Diuretics: papa inoa o nā lāʻau, nā hana o ka hana

Hoʻopilikia maoli nā lāʻau Diuretic i ka hana a ka wikiwiki a wikiwiki i ke kaʻina o ka urine excretion.

Ka hana o ka hana o ka hapanui o nā diuretics, ʻoiai inā he paʻakai potassium-sparing, ua kau ʻia i ka hiki ke kīpē ʻana i ke kūoʻi ʻana i loko o nā pūhaka, ʻoi aku ka nui o ka pūne renal, electrolytes.

ʻO ka hoʻonui ʻana i ka nui o nā electrolytes i hoʻokuʻu i ka manawa like me ka hoʻokuʻu ʻana i kekahi nui o ka wai wai.

ʻO ka diuretic mua i kū mai i ka kenekulia 19, i ka manawa i loaʻa ai kahi lāʻau lapa kala, kahi i hoʻohana nui ʻia e mālama i ka syphilis. Akā e pili ana i kēia maʻi, ʻaʻole pono ka lāʻau, akā ua ʻike ʻia kona hopena diuretic ikaika.

Ma hope o kekahi manawa, ua hoʻololi pono ke hoʻomākaukau i ka mercury me kahi mea e ʻemi ʻole ʻia.

ʻAʻole liʻuliʻu, hoʻololi i ke ʻano o ka diuretics i alakaʻi i ka hoʻokumu ʻana i nā lāʻau diuretic ikaika loa, aia kā lākou papa inoa ponoʻī.

He aha nā mea diuretics no?

Hoʻohana pinepine ʻia nā lāʻau diuretic e:

• me ka hemahema o ka cardiovascular,
• me ka edema,
• e hōʻoia i ka hopena o ka urine ma ka hihia o ka hana pū ʻole i kau ʻia
• haʻahaʻa haʻahaʻa kiʻekiʻe koko,
• i ka mea e make ai, e hoʻoneʻe i nā toxins.

Pono e hoʻolilo ʻia he mea maikaʻi ka diuretics no ka hypertension a me ka hoʻopiʻi ʻana o ka puʻuwai. Hoʻopili kēia mau maʻi me ka lohi i ka sodium o ke kino. Hoʻopau i nā lāʻau lapaʻau Diuretic ka nui o ka hōʻiliʻili ʻana o kēia waiwai a no laila e hōʻemi i ka pupuhi.

Me ke kiʻekiʻe o ke koko, ʻoi aku ka nui o ka sodium e pili ana i ka musika o nā kīʻaha koko, e hoʻomaka ana e wāwahi a paʻa. ʻO nā lāʻau diuretic i hoʻohana ʻia ma ka antihypertensives e holoi i ka sodium o waho o ke kino a hoʻolaha i ka vasodilation, kahi e hoʻohaʻahaʻa i ke koko.

Ke hoʻopau nei nā lāʻau ʻawaʻawa, kekahi o nā meaʻala a hoʻopā ʻia e nā keiki. E hoʻolōʻihi i kēia kaʻina hana, hoʻohana ʻia nō hoʻi diuretics. I ka lāʻau lapaʻau lāʻau maʻi, ua kapa ʻia kēia ʻano ʻo "Force diuresis."

ʻO ka mea mua, ua hoʻokaʻawale ʻia ka nui o nā hopena i ka poʻe maʻi, a laila hoʻohana ʻia kahi diuretic maikaʻi loa, e hoʻoiho koke ana i nā kahe mai ke kino, a me nā mea huna.

Diuretics a me kā lākou papa

No nā maʻi āpau, hāʻawi ʻia ka diuretika kikoʻī i loaʻa ka ʻano ʻokoʻa o ka hana.

1. ʻO nā lāʻau hōʻeha e pili ana i ka hana o ka epithelium renal renal, papa inoa: Triamteren Amiloride, Ethacrylic acid, Torasemide, Bumetamide, Flurosemide, Indapamide, Clopamide, Metolazone, Chlortalidone, Methclothiazide, Bendroflumethiozide, Hydrochlorazole
2. Hoʻopuka Osmotic: Monitol.
3. Hoʻololi ka potasium-sparing diase: Veroshpiron (Spironolactone) pili i nā antagonist o nā kaola mineralocorticoid.

Ka helu ʻana i nā diuretics e ka maikaʻi o ka ʻoni i ka paʻakai mai ka ʻōpū.

• Ineffective - kāpae i ka sodium 5%.
• Ka hana haʻahaʻa - 10% o ka sodium e excreted.
• Kūpono ka maikaʻi - hoʻihoʻi ma mua o 15% sodium.

Ka mīkini o ka hana o ka diuretics

Hiki ke aʻo ʻia ka mīkini o ka hana o ka diuretics e ka hoʻohālike o kā lākou hopena pharmacodynamic. No ka hoʻohālikelike, loaʻa ka emi ʻana o ke koko ma muli o nā ʻōnaehana ʻelua:

1. Hoʻemi i ka hoʻoliilo sodium.
2. ʻO ka hopena pololei i nā kīʻaha koko.

No laila, hiki ke hoʻopau ʻia ka hypertension aʻai i ka hoʻemi ʻana i ka nui o ka wai me ka mālama lōʻihi o ka leo vascular.

ʻO ka emi ʻana o ke koi o ka oxygen i ka pūlima puʻuwai ma ka hoʻohana ʻana i ka diuretics e pili ana:

• me ka pōpilikia i ke aʻalolo pūpū
• me ka hoʻomaʻemaʻe ʻana o nā microcirculation i loko o nā keiki,
• me ka hoʻēmi ʻana i ka paila platelet,
• me ka hoʻemi ʻana o ka ukana ma ka ʻaoʻao hema hema.

ʻO kekahi diuretics, no ka laʻana ʻo Mannitol, ʻaʻole wale nō e hoʻonui i ka nui o ka wai excreted i ka wā o ka edema, akā hiki pū nō ke hoʻonui i ke kīmia o ka osmolar i loko o ke kahe interstitial.

ʻO ka diuretics, ma muli o ko lākou mau waiwai, e hoʻomaha i nā māla palalike o nā arteri, bronchi, a me nā kumu pīpī, he hopena antispasmodic.

Nā hōʻailona no ka koho ʻana o nā diuretics

ʻO ka hōʻailona maʻamau no ke koho ʻana o ka diuretics ka maʻi hypertension arterial, ʻo ka hapanui o kēia mau mea pili i nā maʻi maʻi. Ua kuhikuhi ʻia nā lāʻau diuretic no ka mālama ʻana o ka sodium. Ke paʻa nei kēia mau ʻano i ka ascites, pine a me ka ʻole ka naʻau.

Me ka osteoporosis, ua kuhikuhi ʻia ka mea maʻi i ka diuretics thiazide. Hōʻike ʻia nā lāʻau lapaʻau kōpane o ka maʻi laena Liddle syndrome (kahi e pau ai ka nui o ka pāhana a me ka mālama o ka sodium).

Hoʻopilikia ka diuretics loop i ka hana o ka renal, i kuhikuhi ʻia no ke kaomi intraocular kiʻekiʻe, glaucoma, edema cardiac, cirrhosis.

No ka mālamaʻana a me ka pale ʻana i ka hypertension arterial, kuhikuhi nā kauka i nā lāʻau thiazide, kahi i nā wai liʻiliʻi he hopena akahai ka poʻe maʻi me ka maʻi hypertension. Ua hōʻoia ia aia ka diuretics thiazide ma prophylactic doses hiki ke hoʻemi i ka hopena o ka maʻa.

Ke lawe ʻole ʻia nei i kēia mau lāʻau i ke koena kiʻekiʻe, he puʻu ʻia me ka hoʻomohala ʻana o ka hypokalemia.

I mea e pale ai i kēia kūlana, hiki ke hoʻohui pū i nā diuret thiazide me ka diuretics potassium-sparing.

I ka mālamaʻana i ka diuretics, hōʻikeʻokoʻa ka hana a me ke kākoʻo kākoʻo. Ma ka hana ikaika, ua hōʻike ʻia nā hemahema haʻahaʻa o ka diuretics (Furosemide). Me ka mālama mālama maʻi maʻamau, hoʻohana maʻamau i ka diuretics.

Nā maʻi hoʻohālikelike i ka hoʻohana ʻana o diuretics

ʻO ka poʻe maʻi me ka cirrhosis decompensated o ka palani, hypokalemia, hoʻohana ʻia i ka diuretics. ʻAʻole i kuhikuhi ʻia ka diuretics Loop no nā poʻe maʻi e hōʻole nei i kekahi derivatives sulfanilamide (hypoglycemic a me nā lāʻau maʻi antibacterial).

No ka poʻe me ka ʻōpū o ka hanu ʻana a me ke aʻa ʻole o ka renal, ua hui ʻia ka diuretics Ua hoʻohālikelike ʻia nā diuretics o ka hui thiazide (Methiclothiazide, Bendroflumethiozide, Cyclomethiazide, Hydrochlorothiazide) i ke ʻano type diabetes diabetes mellitus, me ka mea maʻi e hoʻonui koʻikoʻi i nā pae glucose koko.

Vientricular arrhythmias pū kekahi mau contraindications pili i ka wae ʻana o ka diuretics.

No nā mea maʻi e lawe ana i ka paʻakai lithium a me nā glycosides cardiac, ua kuhikuhi ʻia ʻo ka diuretics loop me ka mālama nui.

ʻAʻole i kuhikuhi ʻia ka diuretics Osmotic no ka pohō o ka naʻau.

Nā hopena hopena

Hiki i nā diuretics ma ka papa inoa thiazide ke hoʻonui i nā kao acid uric. No kēia kumu, ʻike ʻia nā mea maʻi me ka gout e hele ai i kahi ʻano nui.

Hiki i nā diuretics o ka hui thiazide (hydrochlorothiazide, hypothiazide) hiki ke alakaʻi i nā hopena hikiʻole. Inā ua koho ʻia ka hewa hala a i ʻole palaualolo ʻole ka mea maʻi, hiki mai nā hopena aʻe:

• lie kanikela
• hiki ke maʻi
• ninini
• nāwaliwali
• ka malo maloʻo
• hiamoe

ʻO kahi hemahema o nā pēpē e komo:

1. ho'ēmi i libido i nā kāne,
2. nā pepeke
3. hoʻonui i ke kō,
4. He huʻueʻe ʻōiwi o nā māla
5. nāwaliwali mānoʻi
6. arriralia.

Nā hopena ʻili o ka furosemide:

• hoʻemi i ka paʻakai, magnesium, calcium
• āhāhuʻe
• ninini
• ka malo maloʻo
• nā hoʻomaʻa pinepine ʻana.

Me kahi loli i ka hoʻololi ʻana o ka mika, ka pae o ka uric acid, ka glucose, ka nui o ka calcium, e komo ai i nā:

• aloha
• ʻili kino ʻili,
• lohe pio.

ʻO nā hopena ʻaoʻao o nā antagonist aldosterone:

1. ʻili kino ʻili,
2. kekekekikia
3. nahoa
4. lie kanikela
5. nā ʻeha, hoʻohemo.

I nā wahine me ka kumu hewa a me ka hewa hewa e nānā ʻia:

Ka hoʻomaʻamaʻa ʻana o ka hypertension arterial i ka maʻi diabetes. Diuretics

Diuretics (diuretics) ʻo ia kekahi o nā hui nui o nā antihypertensives ma muli o kā lākou efficacy kiʻekiʻe, ke kamaʻilio maikaʻi me ka uku haʻahaʻa a me ke kumu kūʻai. I kēia manawa, me ka hypertension arterial, ʻoi aku ka thiazide (hypothiazide, hydrochlorothiside, etc.) a me ka thiazide-like (indapamide, chlortalidone, xipamide) e hoʻohana ʻia, ka hopena e pili ana me ka hoʻonui ʻia me ka hoʻonui ʻia i ka pā ʻana o ka sodium.

Hoʻohana ʻole ʻia ʻo Loop diuretics (furosemide, etc.) no ka lōʻihi o ka mālama ʻana i ka maʻi hypertension arterial, akā hōʻike ʻia lākou no nā mea maʻi me ka hoʻēmi ʻana i ka hana renal ma kahi o ka thiazide diuretics. Ua pau ka nui o ko lākou manaʻo no ka mālama ʻana i ka maʻi hypertension.

Aia a hiki i kēia manawa, ua hoʻohana nui ʻia ka diuretika thiazide no ka mālamaʻana i ka hypertension arterial i ka maʻi type type 2 no ka hiki ke hōʻemi i ka hoʻowalewale o nā ʻoli i ka insulin, hoʻonui i ka glucose, me ka cholesterol a me ka triglycerides i ke koko.

Eia nō naʻe, ua ʻike ʻia aia kēia mau hopena hopena me ke hoʻohana lōʻihi ʻana i nā inikua nui o nā lāʻau lapaʻau, a ma nā wahi liʻiliʻi ʻaʻole lākou i hoʻopilikia nui i ka metabolate a me ka lipid metabolism. ʻO ka diuretics like-thiazide a like me ka diuretics like ʻole e hoʻoneʻe wale i ka sodium, akā, ʻo ka paʻakai a me ka magnesium mai ke kino.

ʻO ka nui o ka ʻai o nā meaʻai i momona i ka paʻakai a me ka magnesium (huaʻai hou a maloʻo a me nā hua, nā lau, nā ʻala kuke, ka oatmeal a me ka buckwheat, etc.) e pale ai i ke kino mai ka hoʻohemo ʻana o kēia mau minuke. I ka lawe ʻana i ka thiazide hoʻohui a me ka diuretics pākeleka o ka potassium (triampur, triamco), he liʻiliʻi loa ka lilo ʻana o ka paʻakai.

Thaizide like-diuretics e pili iki i ka hoʻoliʻi a me nā lipid metabolism e hōʻike ʻia no ka hui pū ʻana o ka hypertension a me ke ʻano type type 2 mellitus, ʻoiai ka mea e pono ai i ka insulin e hoʻonui i nā mea maʻi e hōʻaia ʻia me ka insulin. ʻO ka lāʻau lapaʻau o ke koho mua he indapamide retard (arifon), lawe ʻia 1 manawa i kēlā me kēia lā.

Ma ke ʻano o ka mālama ʻana i nā Na me nā wai a me ka hypervolemia hopena e lilo i kuleana nui i ka genesis o ke ʻano hypertension i ka ʻano type type 1 a me ke ʻano type 2, ua kūpono ka hoʻohana ʻana i ka diuretics e hoʻomaʻamaʻa i ke koko. Eia nō naʻe, ʻaʻole like like nā hui diuretic a me ka maikaʻi i ka poʻe maʻi me ka maʻi maʻi.

Kahi ʻano o ka diuretics

Thiazide diuretics ʻO kēia mau lāʻau ke hana nui ma nā ʻoli o ka tubule convoluted distalula mai loko, kahi e kālai ai lākou i ka diuretics e hele mai ana he 1-2 mau hola ma hope o ka lawelawe waha a mau loa, ma ke ʻano he kānāwai, 12-18 mau hola (hypothiazide) a hiki i 24 mau hola (chlortalidone). ʻO Diuretics Thiazide ka ikaika o ka paʻika-diuretics.

ʻO ka hana o ka maʻi maʻi o ka maʻi thiazides ma muli o ka huaʻōlelo hoʻoneʻe i ka hopena excretory o kēia mau lāʻau. ʻO ka nalowale o ka pākuʻi extracellular a me ka intracellular i loko o ka β-cell o ka pancreas ma lalo o ka mana o thiazides e alakaʻi i ka huna ʻana i ka insulin a me ka hyperglycemia. ʻOi aku ka weheʻana o ka diuretic potassium, ʻoi aku ke kiʻekiʻe o ka hopena diabetes.

I kahi noiʻina kikoʻī o ka diuretics thiazide, ka mea i huli ai i ka hopena o ka potassium-excreting o thiazides kahi kūʻokoʻa wale nō i ka kūlohelohe. Hoʻololi ʻia kahi hopena o ka pālea o ka pākia-hoʻoneʻe o ka hypothiazide (ʻo ka diuretic thiazide ʻoi loa ka hoʻohana ʻana i Russia).

No laila, me kahi nui o ka hypothiazide o 12,5 mg / lā a i ʻole ka liʻiliʻi, ua mālama ʻia kona hopena potassium-excreting.Inā kūpaʻa ʻia ka ikaika o ka hopena o ka pāhaia o ka pā o thiazides, a laila pili ka hopena o ka maʻi diabetes i kēia mau diuretics (pili pono i ka paʻū o ka pāhare pāpato), e like hoʻi me ka dosis, i.e., e loa ma ka nui loa o nā lāʻau o ka lāʻau a me ka liʻiliʻi ma ka haʻahaʻa.

ʻOiaʻiʻo, ua hōʻike nā noiʻi multicenter i ʻoi aku ka liʻiliʻi o ka nui o ka thiazide i lawe ʻia, ʻoi aku ka hopena i ka metabolism. Me ka nui o ka maʻi o ka hypothiazide ma luna o 50 mg / lā, ua hōʻeha ʻia ka hopena o ka maʻi diabetes type 2 a i ka 7% (noiʻi ʻo MRFIT), me ka nui o ka maʻi 25 mg a i ʻole ka nui, ʻaʻole i loaʻa ka piʻi nui o ka hopena o ka maʻi maʻamau (type 2, SHEP, ʻo TOMHS aʻoi ʻana).

I ka nui o ka nui o ka noiʻi ARIKI, ka mea i loaʻa ma mua o 12,000 mau poʻe me ka maʻi ʻole o ka maʻi maʻi, hōʻike ʻia ka lawe ʻana i ka diuretics thiazide ma ke ʻano o 12.5-25 mg / lā no 6 mau makahiki ʻaʻole i ukali ʻia e ka piʻi nui ʻana o ka maʻi maʻamau type 2 (OP = 0.91) . ^ E Ha yM.

No laila, ua hōʻoia ka noiʻi multicenter i hoʻopaʻa ʻia i ka hopena o ka hoʻomohala ʻana i ka maʻi diabetes de 2 de novo me ka hoʻohana lōʻihi ʻana i ka diuretics thiazide he liʻiliʻi ka nui o kā lākou maʻa ma mua o 25 mg / lā.

ʻO ka hopena o ka diuretika thiazide ma ka lipid metabolism ka mea hilinaʻi nui aku i ka lōʻihi o ka lāʻau a i ka wā e hōʻemi ʻia ai i kona ʻano. No laila, i ka wā e lawe ai i ka thiazides no 3-12 mahina. hoʻonuiʻia ka nui o ka serum cholesterol ma ka 5-7%.

I ka manawa like, hōʻike nā hoʻokolihino hoʻokolohua random-placebo i hōʻike ka lōʻihi o ka hoʻohana ʻana i nā lāʻau (no nā makahiki 3-5) ʻaʻole i hoʻopilikia ʻia ka metabolism lipid. Ma nā haʻawina ʻo HAPPHY a me EWPHE, ua ʻike ʻia ka baseline hypercholesterolemia (he nui ka serum OX ma mua o ka 6.5 mmol / L).

No laila, ʻaʻohe mea hōʻoiaʻiʻo ʻaʻole hiki ke kuhikuhi ʻia ka diuret thiazide i nā poʻe me ka dyslipidemia, inā pono lākou e hōʻemi i ke koko.

Ke hele nei i mua o nā patula, he ʻokoʻa ka nui o nā loina o ka mālama ʻana i ka maʻi hypertension, ma muli o ka paleʻole o ka pauku o ka paʻakai. No laila, me ka hypertension a me ke ʻano type diabetes 2, pono ia e hoʻokau mua i ka hoʻohui antihypertensive hui.

I kēia manawa, nā hui pū e pili ana i ka hoʻohana ʻana o ka angiotensin II a me nā ACE inhibitors ke manaʻo ʻia ʻo ka ʻoi aku ka maikaʻi. Hoʻouna ʻia e hoʻohui i kēia mau lāʻau me nā beta-blockers a me diuretics. Hāʻawi ʻia nā hopena maikaʻi e ka hui pū ʻana o nā ACE inhibitors a me antagonist calcium.

I ka poʻe me ka maʻi maʻi, e piʻi ka piʻipiʻi ma muli o ka hoʻonui ʻana o ka nui o ke kahe koko. Eia kekahi, ʻo nā mea maʻi i kēia pūʻulu hiki i ka paʻakai, no laila ua kau ʻia lākou i nā ʻano ʻano diuretics:

• hoʻomāneila - chlortalidone a me hypothiazide,
• thiazide-like indapamide,
• hūpeke manu - lasix and furosemide,
• Kōmela-mālama - veroshpiron.

Hiki i nā diuretics ke hoʻoikaika i ka hana o kahi inhibitor ACE, ma muli o ia e hoʻohana nui ʻia e nā kauka no ka mālama ʻana i ka hypertension arterial. Akā, e like me kekahi lāʻau lapaʻau, loaʻa ko lākou mau palena i ka hoʻohana ʻana.

Ua hoʻohālikelike ʻia ʻo Tizoid diuretics no ke ʻano maʻi type 2 me ka mālama akahele, ʻo ka nui o nā nui i hāʻawi ʻia i nā hoʻonui o ke kō o ke koko o ka kolamu a me ke kō A me kahi loaʻa ʻole o ka pūpū, kahi hanana maʻamau i ka maʻi maʻi maʻi, hiki i ka lāʻau ke hōʻemi i ka hana o nā keiki. ʻO kekahi hoʻi kahi contraindication o ka diuretics tizoid.

ʻO nā diuretics like-Thiazide i ʻole ka hoʻohālikelike ʻole ʻia me nā papa inoa ACE. He ʻano diuretic ka hopena o kēia ʻano, ʻoiai ʻaʻole ka hoʻopiʻi i ka ʻōpū a ʻaʻole i kōkua i ka hoʻopau ʻana o ka pāhare.

Hoʻopau i ka diuretics i ka ulu hypertension, i hui pū ai me ka maʻi diabetes type 2, ʻokoʻa ke hoʻākāka ʻia e nā kauka no ka ulu ʻana o ka diuresis a me ka excretion potassium. Eia nō naʻe, ʻo kā lākou pono he hui hoʻohui maikaʻi me nā ACE inhibitors, kahi mea nui loa ia i ka hāʻule ʻole ʻana o ka renal. A hoʻonui ka potassium i ka wā e lawe ai i ka Lasix a me Furosemide e hoʻopiha hou ʻia ma muli o ke kau hou o ka paʻakai.

Hoʻokomo ʻia ka lāʻau paʻakai pākela-waʻa ʻo Veroshpiron i ka manawa no ka mālama ʻana i ka maʻi hypertension, akā pono e noʻonoʻo ʻia ma ka hopena o ka renal i kona hoʻohana ʻana.

Nā lāʻau lapaʻau i pāpā ʻia

He aha nā papa antihypertensive e hoʻopilikia i ka maʻi maʻi maʻi? Hoʻokomo ʻia, diuretics hōʻino no ka maʻi hānai me Hypothiazide (kahi diuretic thiazide). Hiki i kēia mau peni ke hoʻonui i ka glucose o ke koko a me nā pae kolamu maikaʻi. Ma mua o ka hāʻuleʻole o ka renal, hiki i ka mea maʻi ke loaʻa i kahi pōʻino i ka hana o ke kino. ʻO nā maʻi me ka hypertension e kuhikuhi i ka diuretics o nā hui ʻē aʻe.

ʻO ka lāʻau Atenolol (β1-adenoblocker) no ka maʻi mellitus type 1 a me 2 e hoʻonui ai i ka piʻi a emi paha i ka pae o ka glycemia.

Me ka mālama aka, ua kuhikuhi ʻia no ka hoʻopōʻino ʻana i nā keiki, puʻuwai. Me ka nephropathy, hiki i Atenolol ke hōʻemi i kahi nui o ke kaʻe o ke koko.

Hoʻololi ka lāʻau lapaʻau i nā kaʻina metabolic, ka nui o nā hopena o ka hopena mai ke kaʻe, kūwili ʻana, a me ka ʻōnaehana cardiovascular. E kūʻē i ke kiʻi ʻana o ka lawe ʻana i ka Atenolol i nā ʻano diabetes mellitus type 2, ua ʻike ʻia ke koko haʻahaʻa loa.

Hoʻopilikia kēia i ka hōʻino koʻikoʻi i ka mālama pono. ʻO ka lawe ʻana i ka lāʻau lapaʻau hiki iā ia ke paʻakikī i ka pae ʻai koko.

I nā poʻe maʻi e hilinaʻi nei i ka insulin, hiki i ka Atenolol ke hōʻeha i ka hypoglycemia ma muli o ke hoʻokuʻuʻana o ka glucose i ka lolo, a me ka hana o ka insulin. He mea paʻakikī i ke kauka ke hoʻoponopono pololei i ka maʻi maʻamau, me ka mea ʻaʻole i haʻi ʻia nā hōʻailona.

Hoʻopili ia, hōʻemi ʻo Atenolol i ka mālamaʻana i nā kiko o ke kino i ka insulin, e alakaʻi ana i ka hōʻeha i ke kūlana o nā mea maʻi me ka maʻi type 2, he hōʻemi ma ka pae kaulike o nā kolu maikaʻi a me ka hopena, a kōkua i ka hyperglycemia.

ʻAʻole hiki ke pani koke ʻia ka loaʻa ʻana o Atenolol; pono e kūkā i ke kauka e pili ana i kona hoʻololi a hoʻoiho i nā ʻano ʻē aʻe. Ua hōʻike ʻia nā noiʻi ʻepekema ʻo ka hoʻohana lōʻihi o ka Atenolol i nā mea maʻi me ka hypertension lohi i ke alakaʻi ʻana i ka type 2 diabetes mellitus, ʻoiai ke hoʻololi nei i ka hoʻololi ʻana o nā io i ka insulin.

ʻO kekahi ʻano ʻē aʻe iā Atenolol ʻo Nebilet, kahi β-blocker ʻaʻole ia e hoʻopilikia i ka hana metabolism a he hopena vasodilating i hoʻolaha ʻia.

Pono e koho pono i nā papa no ka hypertension i ka maʻi maʻi a kuhikuhi ʻia e ke kauka e hele ana i ka nānā i nā ʻano kumuhana o ka mea maʻi, ka loaʻa ʻana o nā contraindications, ka paʻakikī o ka papa hana. ʻAʻole ia e hoʻohana i ka hoʻohana i ka β-blockers (Atenolol), diuretics loop, no ka mea ke hoʻopilikia maikaʻi kēia mau lāʻau i nā kaʻina metabola, hoʻonui i ka pae o ka glycemia a me ka haʻahaʻa cholesterol haʻahaʻa.

ʻO ka papa inoa o nā lāʻau pono e komo i nā sartans, thiazide-like diuretics (Indapamide), ACE inhibitors.

ʻO nā hōʻola kanaka a me nā ʻano

He aha nā mea diuretics e nīnau pinepine ai i kāu kauka. Diuretics kahi diuretics o kahi ʻano hana like ʻole me ka hopena diuretic i ʻōlelo ʻia. Eia nō naʻe, he hopena maikaʻi lākou a pau a me kā lākou hoʻohana ʻana me ke ʻole o ka ʻōlelo a ke kauka, he pōʻino i ke olakino. He aha nā mea diuretics?

Ka papa ʻōlelo - nā ʻano o ka diuretics

Hoʻoulu ʻo Diuretics i ka hana o nā inhibitor ACE, no laila, ua kuhikuhi ʻia no ka mālama paʻakikī. ʻO ka diuretics like-Thiazide ka hopena ʻoluʻolu i ka type 2 diabetes mellitus, ka liʻiliʻi o ka hopena o ka pā paʻakai, ka nui o ka glucose a me nā lipids i loko o ke koko, a ʻaʻole e hoʻōkiu i ka hana o nā kuli.

Huina pū kekahi hui ʻo Indapamide lāua ʻo Arefon Retard. Loaʻa i nā lāʻau nā hopena nephroprotective i kēlā me kēia wahi e hōʻino ai i ke kino.

Hoʻokomo ʻo Indapamide i ka vasodilation, hoʻoulu i ka hana o nā blockers aggregation blockers, ma muli o ka lawe ʻana i ka lāʻau lapaʻau no ka maʻi type type 2, ke kau ʻana o ka atrium a me ka hoʻohaʻahaʻa i ke koko.

I nā inika therapeutic, ʻo ka indapamide e hana wale i ka hopena hypotensive me ka nui o ka hoʻonui nui ʻana i ka hopena o ka urine.ʻO ka wahi nui o ka hana a Indapamide ʻo ia ka ʻōnaehana vascular a me ka jaringan renal.

ʻAʻohe pili i ka Indapamide i nā kaʻina metabola i loko o ke kino, no laila ʻaʻole ia e hoʻonui i ka pae o ka glucose, nā lipoproteins haʻahaʻa haʻahaʻa. Hoʻomaʻamaʻa koke ʻo Indapamide i kā lākou gastrointestinal tract, akā ʻaʻole kēia e hoʻemi i kona pono, e ʻai iki me ka hoʻoluliluli ʻana i kahi kīnā.

Hiki i ka indapamide lōʻihi lōʻihi ke hōʻemi i ka nui o nā lāʻau lapaʻau. Loaʻa ka hopena therapeutic i ka hopena o ka pule mua o ka lawe i nā paila. Pono pono e inu i hoʻokahi capsule i ka lā.

He aha nā papa diuretic e hiki ai iaʻu ke inu mai ka kaʻe koko kiʻekiʻe no ka maʻi diabetes?

Ua hoʻākāka ʻia nā papa diuretic no ke koko koko (nui ke koʻikoʻi hypertension) i ke ʻano maʻi type 2. Pono ke kauka komo e koho i nā lāʻau lapaʻau, me ka noʻonoʻo ʻana i ka ʻeha o ka maʻi, ka hōʻino ʻana o ka maʻi kino o ka ʻalā, a me nā contraindications.

Ua kuhikuhi ʻia ʻo Furosemide a me Lasix no ka huhū ikaika i hui pū ʻia me nā papa ACE. Eia kekahi, i nā mea maʻi e loaʻa ʻole ka hana ʻana i ka renal ka hoʻomaikaʻi ʻana i ka hana o ka mea i hoʻopili ʻia. Hōʻalo nā lāʻau i ka pāhana ma waho o ke kino, no laila, pono e lawe i nā huahana pā-paʻakai (Asparkam).

ʻAʻole holoi ʻo Veroshpiron i ka paʻakai mai ke kino o ka mea maʻi, akā ua pāpā ʻia ʻo ia no ka hoʻohana ʻana i ka hana ʻole ʻole. Me ka maʻi maʻi, hoʻokaʻawale ʻia ka lāʻau me ke ʻano lāʻau.

Hiki ke mālama ʻia ka maʻi hypertension me nā ala ʻē aʻe no ka maʻi maʻi ma lalo o ka mākaʻikaʻi koʻikoʻi o kahi kauka. No ka mea ʻaʻole kūpono nā lāʻau āpau a palekana ʻole.

He lōʻihi loa ka lāʻau lapaʻau, mālama ʻia i kekahi manawa i mau mahina a ʻeono mau malama e mālama ai iā ia. Eia nō naʻe, pono ka laʻa o ke ʻano o nā mea kanu a me nā uku me ka pohō, e pono ai i ka ʻehiku a ʻehiku mau lā.

I ka hoʻonuiʻana i nā lāʻau lapaʻau no nā pilikia me ke kaomi ʻana i ke ʻano o ka maʻi diabetes mellitus type 2, pono pono e hānai ʻia nā mea kanu kūikawā.

Pehea e koho ai i nā papa diuretic

No nā maʻi like ʻole ke ʻano, ua koho ʻia kekahi ʻano o ka diuretics:

• ʻO ka saluretics - diuretics, e wehe i nā pāhare me ka magnesium ions, e waiho ana i ka hopena diuretic:
  • loopback - furosemide, bumetanide, torasemide, lasix, ethacrylic acid
  • sulfonamides - chlortalidone, clopamide (maʻa mau chlortalidone, hoʻohana ʻia ka clopamide e hui pū me nā beta-adenoblockers, me nā lāʻau antihypertensive), indapamide - kahi lāʻau hypotensive
  • thiazide - cyclomethiazide, hypothiazide
  • carbonates anhydrase inhibitors - acetazolamide, diacarb
• Diuretics pākuhi-ka paʻakai - hana i ka pūkō i waho, e pale ai i nā kahe pālio - amiloride, spironolactone, triamteren, veroshpiron, eplerenone
• Hoʻokomo ka diuretika Osmotic i ka hoʻihoʻi ʻana o ka wai ma muli o ka ʻokoʻa i ke kaomi osmotic i ka tubule - mannitol, urea (lawelawe intravenous).

He aha ke kuhikuhi ana nā kauka:

• Hiki i ke kala (ke koko nui ke koko) - thiazides a me indapamide
• ʻO ka ʻeha a me ka puʻuwai o ka naʻau o ka naʻau he loop diuretics. E pale aku i ke kua o ka puʻuwai puʻuwai, ke kūpaʻa ʻana o ka wāwae ikaika ke alakaʻi o nā makua i ka furosemide a i ʻole ka lasix.
• Di Diabetes, metabolic disorders - indapamide
• Hoʻonui ka pili huna adrenal o aldosterone - spironolactone
• ʻOsteoporosis - Thiazides

Hiki i ka hana o ka diuretics ke māhele ʻia i loko o:

Ma ka lōʻihi

Nā hana lōʻihi (a hiki i 4 lā)Eplerenone, Veroshpiron, Chlortalidone Nā waʻa waena (a hiki i ka 14 hola)Diacarb, Clopamide, Triamteren, Hypothiazide, Indapamide Ka hana pōkole (a hiki i 8 mau hola)Lures, Furosemide, Lasix, Torasemide, Ethacrine acid

Nā diopetics Loop

Hoʻopili i nā diuretika Loop i ka hoʻonui ʻana o ka sodium e nā keiki, a, ʻo ia hoʻi, i ka wai. Hoʻopau lākou i kahi hoʻoikaika ikaika, ʻoi aku ka wikiwiki, akā i ka manawa diuresis pōkole (ʻaʻole iʻoi aʻe ma mua o 6 mau hola), no laila hana maʻamau lākou no ka mālama olakino.I ka hopena o ka naʻau paʻakikī me ka edema koʻikoʻi, hiki ke hoʻohana i kā lākou hoʻohana i nā papa pōkole.

He kūpono kēia mau diuretics no ka hana ʻana i ka pūmaʻa like ʻole, e like me nā mea ʻē aʻe. Akā inā i ka wā e lawe ai i ka diuretics loop, ua nalowale ka nui o nā konane a me ka pākeke i loko o ke kino, e hoʻopōʻino kēia i ka hana o ka naʻau.

Nā maʻi: ke kau ʻana o ka waha me ka anuria, ka nui o ka puna momona, ka hypersensitivity, glomerulonephritis aʻalopō, kaʻi ʻana o ka ʻāmiuki a me ka helu kalima (ʻike i nā pōhaku o nā kēpau), pancreatitis, stenosis urethral, ​​hyperuricemia, gout, myocardial myocardial infarction, mitral myocardial mertial, mitral arterial, mitral arterial , ka haʻalele ʻana o ka metabolism-wai.

ʻO nā hopena maikaʻi: tachycardia, kahe nui ʻana, ka arrhythmias, ka hina, ka nāwaliwali, ka hoʻohālikelike, ka ʻeha, ka luhiluhi, ka dizz, ke kīnā ʻole, a me ka ʻike, ka waha maloʻo, ka lua, ka luaʻi, ka makewai, ka hoʻohaʻahaʻa, me ka hoʻōho o ka pancreatitis, ka hoʻomau ʻana o ka urinary, hōʻemi. potencies, hematuria, interstitial nephritis, ʻiliʻeha, ʻala, ʻoluʻolu, photosensitivity, erythema, dermatitis, pīhoihoi anaphylactic, ʻehaʻīkuʻi o nā wāwae, nā ʻōpū palupalu, etc.

Furosemide 40 mg. 50 pcs. 20-30 rub.Lasix 40 mg. 45 kiʻi. 50 ʻōpala Kāleka 10 mg. 30 mau nāona 500 mauʻu. 5 mg 30 mau nāona 270 rub.Hoʻololi 10 mg 20 pcs 450 rub., 5 mg 20 pcs. 320 ʻōpala

Suluramide diuretics

Hoʻopili kēia me Indapamide - kahi lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko (diuretic, vasodilator), kahi kokoke i nā waiwai pharmacological i thiazides. Hoʻopilikia ka hopena therapeutic ma hope o ka 1-2 mau pule o ka hoʻokele, hiki i ka nui o ka nui ma hope o 2-3 mau mahina a kū i ke 2 mau mahina.

Nā Contraindications: ka pepeha palupalu nui, hypersensitivity, nā keiki ma lalo o 18 makahiki o nā makahiki, nā wahine i ka wā lactation, me ka lactose intolerance, me ka mālamaʻana i ka wā hapai, me ka nāwaliwali o ka hana wai-electrolyte metabolism, hyperuricemia, hyperparathyroidism.

ʻO nā hopena ʻokoʻa: kahe ʻana o ke koko, palpitations, arrhythmia, hoʻololi ʻo ECG, kōmala, sinusitis, pharyngitis, dizziness, drowsiness, hōʻeha, ka hopohopo, ka hiamoe, ʻōpū, ʻāwīwīwī, hōʻeha, ʻeha, ʻehaʻeha, ka huhū, ka hopohopo, constipation a ʻeha ʻole, ʻeha. pūpulu, waha maloʻo, pancreatitis, nocturia, polyuria, urticaria, ʻeha o ka ʻili, etc.

Indapamide: Akuter-Sanovel, Arindal, Arifon, Indap, Indipam, Indiur, Ionik, Ipres-Long, Lorvas, Retapres, Tenzar, a pū:

Arifona 2,5 mg 30 kiʻi 450 ʻōpala

Indap 2,5 mg 30 kiʻi 100 rub

ʻEkena 2,5 mg 30 kiʻi 50 ʻōpala

Indapamide 2,5 mg 30 kiʻi 100 rub

Ravel 1,5 mg 30 mau nāona 200 rub.

Nā diuretaha Thiazide

ʻO kahi mea e pili ana i ka hana o ka diuretics thiazide ʻo nā tubule distal a o ka pūpū. Kūkulu ʻia ia e ka mea kanu me ka hoʻoneʻe ʻana i nā hakahaka o nā sodium ion, e ukali ʻia e ka wai ma ke ʻano o kahi kipi. ʻO ke kumu, hoʻopuka ʻia ka sodium me ka wai nui.

E like me ke kānāwai, hōʻike ka thiazide diuretics i kahi hopena diuretic o ka ikaika medium. Aia kekahi mau lāʻau lapaʻau i kēia hui pū ka hiki ke hoʻokahe i nā ipu koko.

• Ma muli o ka hōʻemi ʻana o ka pākuʻi o ka pā vascular, hoʻohana nui nā lāʻau diuretic thiazide i loko o ka hoʻohui lōʻihi o ka lāʻau o ka hypertension arterial.
• ʻO ka hiki ke wehe i ka edema kūwaho a me loko.
• Hoʻohana pū ʻia no ka edema pili me ka cirrhosis a me nā nephrotic syndrome.

Hoʻolima koke ʻia nā mea kanu i ka hana ma hope o ka hapalua hola a i ʻole hola ma hope o ka hoʻokō ʻana. ʻO ka lōʻihi o kā lākou hana e pili ana i nā hola 12, e hiki ai iā ʻoe ke inu i ka lāʻau hoʻokahi i ka lā hoʻokahi a me ke ʻano hypotensive a hiki i ka 2 mau wā e hoʻopau ai i ka edema o ka hoʻomakaʻana o ka cardiac. ʻO ka pono o kēia ʻano diuretic, ʻaʻole lākou e hoʻonāukiuki i ka pae kaulike-kumu o ke koko.

ʻO nā hiʻohiʻona o ka lawe ʻana i ka diuretics thiazide:

• Hiki i ka hoʻopili ʻana i nā pae pākela a me ka kōna ʻo magnesium (me ka lōʻihi o ka hoʻokō)
• E hoʻonui i nā pae waikawa uric (undesirable no ka gout)
• E hoʻonui i ke kō i ke kō (pono ʻole no ka maʻi diabetes)

Hoʻomākaukau Thiazide: Gigroton, Hypothiazide, Dichlothiazide, Oxodoline, Cyclomethazide.

25 mg 20 mau kāleka. 100 rub

100 mg 20 mau kāleka. 120 ʻōpala

25 mg 20 mau kāleka. 50 ʻōpala

100 mg 20 mau kāleka. 70 ʻōpala

Hoʻopuka-Diaring konohū

E like me ka hoʻomākaukau ʻana ma thiazide, pili ka diuretics potassium-sparing a hana ma ka pae o nā tubal distal. ʻO ka loiloi o ka hana e like me ka thiazides (hewaʻole i ka hoʻoliʻi o ka sodium) a me kona nalowale me ka wai (Amiloride, Triampur).

ʻO ka Spironolactone ka hopena e kūlike me ka aldosterone (he hormone adrenal e kāohi ana i ka sodium a me ka wai). Eia naʻe, nāwaliwali o ka hopena o ka diuretics pākeleka a hoʻomohala holomua a hoʻomoʻi ikaika (ma o 2-5 mau lā mai ka hoʻomaka ʻana o ka hopena).

• I ka hopena, ʻaʻole kūpono nā diuretics potassium-sparing no ka maʻi diuretic kūʻokoʻa a hoʻākāka ʻia i kahi o ka diuretic o ke ʻano, no ka hoʻohālike ʻana, me ka hyperaldosteronism kūloko, ke kūleʻe o ka naʻau ma ke ʻano kumu, nā maʻi nephrotic, cirrhosis.
• Eia nō hoʻi, ua lilo kēia pūʻulu i nā lāʻau lapaʻau e koho ai no ka hoʻomau ʻana i nā lāʻau i hōʻoki i ka potassium i ka mālama ʻana i nā maʻi naʻau, e like me myocarditis, me ka edematous syndrome.
• Ke hui pū me ka loop a i ʻole thiazide diuretics, nā lāʻau hōʻona i ka potassium-sparing e pale ai i ka lilo nui o ka paʻakai i ka pā.
• Pono ka hyperaldosteronism (adrenal gland tumor) e pono ai ke koho ʻana i ka ʻikepili diuretic (veroshpiron). Ua kūpono nā lāʻau i nā maʻi me ka maʻi mellitus a me nā gout.

Nā mākeke mālama paʻakai: Spironolactone (Veroshpiron), Amiloride, Triamteren (Triampur).

Kūpono diuretics kaulana a me kā lākou hana i ke kino

Hoʻopilikia ka diuretics e hoʻopili nei i ka hana o nā tubula renal i ka sodium e komo hou i loko o ke kino a hana i ka urine. Hoʻopau i ka diuretics o ka hana maʻalahi Methiclothiazide Bendroflumethioside, ʻo Cyclomethiazide e paʻakikī i nā khaline, ʻaʻole wale ka sodium. Ma muli o kēia hana, kapa ʻia lākou i ka saluretics, ʻo ia hoʻi ʻo "ka paʻakai".

ʻO ka diuretics like-Thiazide (Hypothiazide) i kuhikuhi mua ʻia no ka edema, maʻi o ka maʻi, a i ʻole nā ​​puʻuwai naʻau. ʻO ka hypothiazide ka mea kaulana loa e like me ka mea maʻi hypotensive.

Hoʻokuʻu ka lāʻau i ka nui o ka sodium a hōʻemi i ke kaomi i nā lāʻau. Hoʻopili ia, hoʻonui nā lāʻau thiazide i ka hopena o nā lāʻau lapaʻau, ka hana o nā hana e mālama nei i ka hoʻohaʻahaʻa i ke koko.

Ke koho nei i kahi nui o kēia mau lāʻau, hiki ke hoʻonui ʻia ke kahe me ka ʻole o ke hoʻokahe ʻana i ke koko. Hāʻawi ʻia ʻo Hypothiazide no ka maʻi diabetes a me ka urolithiasis.

ʻO nā mea ikaika e kau nei ma ka mākaukau e hōʻemi i ka hoʻoneʻe ʻana o nā calcium calcium a mālama i ka hoʻokumu ʻana o nā paʻakai i loko o nā keiki.

ʻO ka diuretics eʻoi aʻe ka maikaʻi e pili ana iā Furosemide (Lasix). Me ka hoʻokele intravenous o kēia lāʻau lapaʻau, ʻike ʻia ka hopena ma hope o 10 mau minuke. Ua kūpono kēia lāʻau lapaʻau no

• ka paa ʻole o ka ʻūlū hema hema o ka puʻuwai, i hele pū me ka edema pulmonary,
• peripheral edema,
• haehae maʻi
• ka hoopau ana o na mea make.

Hoʻopili ka acidacacic acid (Ureghit) i kāna hana iā Lasix, akā hele ka lōʻihi.

ʻO ka diuretic Monitol ʻoi aʻe ka lawelawe ma intravenously. Hoʻonui ka lāʻau lapaʻau i ka ikaika o ka osmotic o ka plasma a hoʻohaʻahaʻa i ka hoʻoikaika o ka intracranial a me intraocular. No laila, ʻoi aku ka maikaʻi o ka lāʻau i loko o ka oliguria, ʻo ia ke kumu o ka puhi ʻana, i ka trauma a i ʻole ka hopena koko.

ʻO antagonist Aldosteron (Aldactone, Veroshpiron) i ka pale ʻana i nā kao o ka sodium a me nā mea keʻa aku i ka huna o ka magnesium a me nā paʻakai pālolo.Hōʻike ʻia nā lāʻau o kēia pūʻulu no ka edema, hypertension a me ka pulupulu puʻuwai puʻuwai. Hoʻomaʻamaʻa ʻole ka paʻakai-sparing diuretics i nā membrane.

Diuretics a me ke ʻano maʻi type 2

E makaʻala! Pono e noʻonoʻo ʻia me ka diabetes mellitus type 2, hiki wale ke hoʻohana ʻia kekahi mau diuretics, ʻo ia hoʻi, ʻo ke koho pono ʻana o ka diuretics me ka ʻole e noʻonoʻo i kēia maʻi a i ka lāʻau lapaʻau kūlohelohe hiki ke alakaʻi i ka hopena hiki ʻole i ke kino.

Hoʻololi ʻia ʻo Thiazide diuretics no ka mellitus type type 2 ke hoʻokaʻawale loa i ke kahe o ke koko, me ka edema a no ka mālama ʻana o ka maʻi cardiovascular.

KE KUPONO NUI IA!

No ka mālamaʻana i nā hui pū, ua hoʻohana maikaʻi kā mākou mea heluhelu iā DiabeNot. Ke ʻike nei i ka kaulana o kēia huahana, ua hoʻoholo mākou e hāʻawi iā i kou makemake.

Eia nō naʻe, hoʻohana ka thiazide diuretics e mālama i ka hapa nui o nā poʻe maʻi me ka hypertension arterial e mau ana i ka wā lōʻihi.

Ke hōʻemi nui nei kēia mau lāʻau i ka mālamaʻana i nā cell i ka insulin hormone, e alakaʻi ai i kahi hoʻonui o ke koko o ka glucose, triglycerides a me cholesterol. Hoʻopilikia kēia i nā mea pili i ka hoʻohana ʻana o kēia mau diuretics i ka maʻi diabetes type 2.

Eia nō naʻe, ua ʻike ʻia nā noiʻi noiʻi hou e pili ana i ka hoʻohana ʻana i ka diuretics no ke ʻano maʻi type 2 i ʻike pinepine ʻia kēia mau hopena maikaʻi loa me nā kiʻekiʻe o ka lāʻau. Ma nā haʻahaʻa haʻahaʻa, ʻaʻole i kūpono nā hopena kūpono.

Nui! I nā maʻi me ka maʻi diabetes type 2, i ke kuhikuhi ʻana i ka diuretics thiazide, pono e ʻai nā mea maʻi e like me nā mea ʻai he nui a me nā hua. E kōkua kēia i ka hoʻopau ʻana i ka pohō nui o ka paʻakai, sodium, a me ka magnesium. Eia kekahi, pono e noʻonoʻo ka pono o ka hoʻohaʻahaʻa i ke kino o ka naʻau o ka insulin.

Ma ke ʻano 2 diabetes mellitus, ʻo ka mea maʻamau ka nui o ka lāʻau ʻo Indapamide, a i ʻole, ʻo ia ka Arifon derivative. ʻAʻohe Indapamide a me Arifon i like ʻole o ka hopena o ke kōlehu a me ka lipid metabolism, he mea nui loa ia no ka maʻi type o keka.

ʻO nā diuretics ʻē aʻe no ke ʻano maʻi diabetes ʻano ʻelua e hōʻike pinepine ʻia a aia wale nō ke loaʻa inā kekahi mau kūlana.

1. ʻO ka diuretics loop no ka maʻi diabetes huki 2 ke hoʻohana pinepine ʻia i hoʻokahi mau manawa i ka wā e pono ai ka hoʻokō wikiwiki ʻana i ka pīhaʻi koko,
2. ua hoʻohui ʻia ʻo thiazide a me ka diuretics potassium-sparing - i ka wā e pono ai e hōʻemi i ka poho o ka pāhare.

ʻO ka poʻe maʻi me ka hoʻoliʻiliʻi koko koko pono e hoʻomaopopo i ka lawe ʻana i kekahi diuretic hiki ke hōʻeha i ka hopena koʻikoʻi - ʻo ka hoʻemi ʻana o ka naʻau o ka insulin hormone. Eia kekahi, ʻaʻole e lōʻihi ka lōʻihi o ka mālamaʻana i ka hypertension arterial.

Kahi papa inoa o nā lāʻau antihypertensive no ka maʻi type 2

Ua koho pono ʻia nā lāʻau Antihypertensive no ke ʻano maʻi mellitus type 2, i hāʻawi ʻia i kā lākou hopena ma ka hana ʻana o nā pūpū, a me ka hopena i ke ʻano o ka huina o nā momona momona a me nā momi. Hoʻokomo pū ʻia nā maʻi hypertension 80% o kēlā mau mea e hōʻeha nei ma ka hyperglycemia. Hoʻonui ka maʻi maʻi i ka hana ʻana o nā mea kū i loko, e hoʻonāukiuki i nā kaʻina kūlohelohe o nā mea kūlohelohe.

Nā hiʻohiʻona

He paʻakikī ka pane ʻana i nā lāʻau hoʻomanawanui no ka maʻi maʻi ma o nā hopena maikaʻi ʻole, ka hōʻike hōʻike ʻana ma ke ʻano o ka metabolism intracellular impaired.

Koho ʻia ke koho ʻana i nā lāʻau lapaʻau no ka hypertension me ka hyperglycemia i nā kūlana:

• Ka hopena kūpono loa, nā hopena ʻokoʻa loa,
• ʻO ka Cardio a me ka nephroprotective hopena (palekana o ka naʻau a me nā ʻōpū),
• ʻAʻohe hopena i ka hoʻoili ʻana o nā lipids a me ka glucose i loko o ke koko.

ʻO nā lāʻau lapaʻau wikiwiki

Inā kānalua ʻoe i ka pīhoihoi koke i loko o ke koko, kahi lāʻau kūpono kūpono no ka hypertension ma ka maʻi diabetes mellitus e kokoke pono.

Inā he mea kōkua pilikia maikaʻi, hoʻohana ka hopena o ke kino ma mua o 6 mau hola. Nā mea hoʻoikaika ʻokoʻa ma nā inoa o nā inoa kālepa maʻamau:

Nā lāʻau lapaʻau no ka hoʻohana ʻōnaehana ʻana

ʻO ka heluhelu mau ma mua o 130/80 mm Hg. ʻAniā. no ka mea, ua piha nā kolohe me nā hoʻopiʻi microvascular, ka hoʻomohala ʻana o ka atherosclerosis, ka hoʻomohala ʻana o ka angiopathies maʻi maʻi. I kēia hihia, ua ʻōlelo ʻia ka hoʻohana mau ʻana i nā lāʻau lapaʻau, ʻo ia hoʻi ma ka manawa like ma ke ʻano o ka paʻakai a me ka meaʻai momona. Pono ka hopena o ka hopena o ka lāʻau lapaʻau kiʻekiʻe no ka maʻi diabetes. ʻO ka hāʻule ʻana o ke kahe o ke koko i ukali ʻia e kahi mea hoʻokūkū a e hōʻino paha i ka ʻōnaehana cardiovascular o kahi kanaka olakino.

Papa inoa o nā lāʻau lapaʻau ma ʻEulopa

ʻO nā lāʻau lapaʻau kēia mau mea maʻamau ma ʻEulopa:

• Lozol kūlike: indapamide
• Thalitone Generic: chlorthalidone
• Zaroxolyn generic: metolazone
• Aquatensen ʻōhuwela: methyclothiazide
• Aquazide h
• Diuril hoʻohaʻahaʻa: chlorothiazide
• Sodium Diuril hoʻohaʻahaʻa: chlorothiazide
• Enduron ʻōhuwela: methyclothiazide
• Esidrix ʻōhuhi: hydrochlorothiazide
• Nā Microzide ʻōhuhi: hydrochlorothiazide
• Mykrox generic: metolazone
• ʻEtinlelo Pūnaewele ʻōhuwela: bendroflumethiazide
• Saluron ʻōhuhi: hydroflumethiazide
• Renese ʻōhuhi: polythiazide

Wahi a kekahi mau ʻōlelo i waho, ua hoʻohana ikaika ʻia nā lāʻau lapaʻau e like nei:

• metolazone
• kekaulina
• benzthiazide
• polythiazide
• methicothiazide,
• bendroflumethiazide,
• kekahikana
• quinetasone
• thienyl acid, etc.

Kahi papa lāʻau o Rusia a me Belarus

• ʻEkena
• Kūleʻa ʻekena
• Akuter-Sanovel
• Arindap
• Arifona
• Arifon Retard
• Vero-Indapamide
• Indapamide
• ʻO Indapamide Long Richter
• ʻO Stadamide MV Stad
• ʻOihana a Indapamide
• Indapamide Retard-OBL
• Indapamide Retard Teva
• Indapamide Sandoz
• Indapamide-OBL
• Indapamide verte
• Indapamide teva
• Indapres
• Indapsan
• Indap
• Indipam
• Indiur
• Inspra
• Ionikia
• Jonik Retard
• Hōʻike wau iā Long
• ʻĀlana
• Lorvas SR
• Pamid
• RavelSR
• Hoʻokomo hou
• SR-ʻamedlelo ʻia
• Tenzar

Ka papa inoa o nā lāʻau lapaʻau me ka mea ikaika (Hydrochlorothiazidum) :

• ʻO ka hole waiwai
• ʻO ka hole waiwai
• ʻO Hydrochlorothiazide-ATS
• ʻO ka Hypothiazide

Ma muli o ka nui o kēia mau lāʻau e hoʻohana pono ai e mālama i ka hypertension, ua mamao loa kēia papa inoa, akā e pili ana i nā inoa kālepa kumu nui no kēia mau pūhui.

Thaizide diuretics no ka maʻi hypertension arterial

Ua hoʻohana mau ʻia ʻo Thiazide diuretics me ka hoʻomau i ka mālama ʻana i ka maʻi hypertension mai ka wā i puka aʻe ma ka mākeke. ʻO kēia ʻano papa o ka diuretics ka wōlau o ka mālama ʻana i ka maʻi hypertension. Lele liʻiliʻi nā lāʻau lapaʻau e hoʻolaʻa i kekahi maʻi e hiki ke hoʻolilo i ka lōʻihi o ka hoʻohana ʻana, a hōʻike kēia i ke ʻano a me ka palekana o kēia mau pūhui kemika. ʻO ka laʻana huinahui ʻo ka diuretic kaulana loa i ka honua no ka mālamaʻana i ka maʻi hypertension. Hoʻololi ʻo Thiazide diuretics i nā hopena o ka make, ka uha, myocardial infarction a me ka hāʻule ʻole o ka naʻau ma ka maʻi hypertension.

He nui nā alakaʻi kulekele no ka mālama ʻana i ka maʻi hypertension e noʻonoʻo i ka hoʻohana ʻana o diuretics thiazide. Hoʻohana ʻia lākou e like me nā lāʻau lapaʻau mua ma USA (JNC VII) a ua ʻōlelo ʻia no ka hoʻohana ʻana ma ʻEulopa (ESC / ESH). Eia nō naʻe, i ka 2011, ʻo ka National Institutes of Health ma United Kingdom (NICE) ua noi aku i nā kalaka pākelē kalepa (BCCs) ma ke ʻano o nā lāʻau lapaʻau mua ma ko lākou mau kulekele no ka mālama ʻana i ka hypertension pono. Eia nō naʻe, nānā lākou i hiki ke hoʻohana ʻia nā thiazide diuretics e like me ka lālani mua o ka lāʻau i nā hihia i hoʻohālikelike ʻia ai ka CCL, inā ua loaʻa i ka mea maʻi i ka edema a i ʻole ka hopena paʻakikī o ka puʻuwai. Ua hoʻololiʻo Thiazide diuretics ma Australia e angiotensin-hoʻohuli i ka hoʻohui o ka enzyme (ACE inhibitors) ma muli o kā lākou makemake e hoʻonui i ka maʻi o ka maʻi type 2.

ʻO diuretics Thiazide no edema o nā ʻano kumu

Hoʻohana ikaika ʻia nā diuret Thiazide e mālama i nā ʻano edema e like me kēia:

• ʻO ka edema o ka cardiac,

Eia nō naʻe, pono e noʻonoʻo i ka paʻakikī koʻikoʻi puʻuwai paʻakikī (CHF), ka diuretics loop ka mea nui loa.

• Edema o ka maʻi hepatic (me ka cirrhosis),
• ʻO ka Edema o kāna kumu,

Eia nō naʻe, hikiʻole iā lākou ke hōʻeha maikaʻi ʻole a me ka hoʻēmi ʻana i nā kānana glomerular e like me 30-40 milliliters i hoʻokahi minuke. ʻO ka mea maʻalahi metolazone a indapamide ma muli o ka pūnaewele hou o ka hana ma ka tubules proximal.

• ʻO Edema me ka lōʻihi o ka hoʻokele ʻana o nā glucocorticoids.

Diuretics Thiazide a me ka osteoporosis

Hoʻopili pū ʻia kēia hopena e pili ana i ka pale o ka calcium maikaʻi a me ka hoʻohaʻahaʻa ʻana i ka nui o nā mea hoʻohālikelike i nā mea maʻi me ka osteoporosis. Ke ʻano o ka hoʻomohala ʻana o kēia hopena, penei: ʻo ka diuret thiazide hoʻonaninani i ka ʻokoʻa ʻana o nā osteoblasts a me ke kūkulu ʻia ʻana o ka iwi iwi. Mahalo i kēia lohi ka holomua o osteoporosis .

Ma muli o ka hiki ke mālama i ka calcium ma ke kino, hoʻohana ka thiazide diuretics i ka mālama ʻana o:

• Nā maʻi maʻi
• Hokaaulea,
• ʻO Nepilithiasis,
• He makeʻeʻai o ka pilina

Kēia neʻeena kōkuhi

ʻO kēia pūʻulu o nā lāʻau lapaʻau e komo pū me Diacarb. ʻO ka maʻamau, hoʻonui ka enzyme anhydrase enzyme i ka hoʻokumu ʻana o ka waikawa carbonic i loko o kaʻeha mai ka wai a me ke kalapona, e hoʻoiho i ka hoʻolaʻa alkaline o ke koko. Ke kāohi nei i ka enzyme, paipai ʻo Diakarb i ka hoʻonui ʻana o ka sodium i loko o ka pāʻai, ka mea e huki ai i ka wai me ia. I ka wā like me ka urine, ua nalowale hoʻi kekahi nui o ka pāhana. Hāʻawi ʻo Diacarb i ka hopena palupalu, e ulu wikiwiki ka wikiwiki (ma hope o hoʻokahi hola i lawe ʻia i nā papa, ma hope o ka hapalua hola me ka infravenous infusion). ʻO ka lōʻihi loa o ka hana e pili ana i 10 mau hola (4 mau hola me ka lawelawe makua.

Hoʻohana ʻia ka lāʻau no:

• intrertranial hypertension
• hoonui i ke kaomi intraocular
• no ka huakini me ka salicylates a me nā barbiturates no ka alkalization o ka urine
• i ka mālamaʻana o cytostatics
• me ka gout

Pharmacokinetics o thaizide diuretics

ʻO ka diuretika Thiazide, ʻaʻole a me chlortalidone kau maikaʻi i ka gastrointestinal tract (GIT) a hoʻohālikelike nui i ka ate. Chlortiazide ma muli o ka hoʻopili ʻole ʻana ma ka gastrointestinal tract, ua ʻōlelo ʻia i nā kaila nui ai a ʻo ia wale nō ka mālamalama o ka hui diuretics thiazide, ʻo ia hoʻi hiki lawelawe ʻia i ka makua .

Hoʻolaha chlortalidone hele mālie ma muli o ka hoʻolohi lohi ʻana. Hoʻopili pololei kēia mau diuretics i nā protein plasma koko a no laila e hāʻule i loko o ka lumen o nā puna ʻaʻole ma o ka filtration glomerular, akā ma o anion moku hoʻokele .

Hoʻopuka i nā hopena lāʻau i ka diuretics thiazide

Hoʻokomoʻo Thiazide diuretics i ka hopena o ka diuretics loop, ka vitamina D, ka glycosides cardiac, diazoxide, ka hoʻomākaukau lithium, anesthetics. A me ka hana ʻana o ka insulin, ke kōmoli haʻahaʻa haʻahaʻa o ka sulfanylurea, anticoagulants, a me nā uricosuric i ka mālama ʻana i ka gout e hoʻonāwaliwali i ka diuretics thiazide.

ʻO ka diuretics thiazide weliweli loa e hui pū me ka quinidine no ka mea i ke keena o hypokalemia (ʻo kekahi o nā hopena hopena o ka diuretics thiazide, a mākou e kamaʻilio i lalo), hiki i ka quinidine ke hana i ka arrhythmias huluhulu ola.

Hoʻemi ʻia ka hopena o ka diuret thiazide i ka wā i hui pū ʻia me nā anti-inflammatory non-steroidal (NSAIDs) a me nā lipid-hoʻohaʻahaʻa i nā kumu wai kohi cationic.

Me ka hui pū ʻana o ka diuret thiazide me glucocorticoids, piʻi i ka pilikia o ka hypokalemia.

Ka hana o ka hana o ka diuretics thiazide

ʻO nā lālā o kēia papa diuretics he mau benzothiadiazine derivatives. Hoʻohana pinepine ʻia ka hua'ōlelo "thiazide no nā lāʻau lapaʻau me nā hopena like ʻole e loaʻa ʻole kahi mea hoʻoulima thiazide. ʻO ka laʻana, chlortalidone a me metolazone. Ua kapa pololei ʻia kēia mau ʻāpana a me nā diuretics thiazide-like.

Benzothiadiazine - ka makua makua o ka papa o nā molekina o ka diuretics thiazide

ʻAʻole maopopo ka hana o ka hana o ka diuret thiazide i ke hoʻohaʻahaʻa i ke koko. Me ka hoʻomakaʻana o ka thiazides, e hoʻoneʻe ana ke kaumaha ma muli o ka piʻi o ka diuresis, kahi hoʻohaʻahaʻa i ka nui o ka plasma a me kahi hoʻohaʻahaʻa i ka hopena cardiac. ʻO kahi manaʻo kupaianaha ʻo ia me ka hoʻohana mau ʻana diuretics thiazide, ʻike ʻia ka hoʻemi ʻia ʻana o ke kaomi e ka hōʻemi ʻana i ka pale o peripheral (i.e., kumu i ka vasodilation). Ke ʻike nei ka hana no ka hoʻomohala o kēia hopena. Mālama ʻo Thiazide diuretics i ke kahe o ke koko i kekahi hapa ma o ke kāohi ʻana i ka reabsorption o Na, K, a me Cl.

ʻAʻole e like me ka diuretics loop, thiazide diuretics hoʻonui i ka reabsorption calcium i nā paheʻe o ka nephron. Me ka hoʻohaʻahaʻa ʻana i ka pāhana o ka sodium i nā puna epithelial o ka tubule, ʻoi aku ka nui o ka thiazides i ka hana o ka antiporter Na-Ca.

ʻO ka antiporter kahi protein pākīpī ma nā membrane pākuʻi e hoʻoili i nā mea ma o ka membrane.

Mālama kēia i ka hoʻoili ʻana o Ca mai nā cell epithelial i ka ʻiʻo renal interstitial. ʻO ia iho, hoʻoneʻe ka neʻe Ca i ka ulu ʻana o ka wai intracellular Ca, e ʻae ana i ka Ca e hoʻokaʻawale aku i nā lumen o nā tubule i loko o nā puna epithelial ma o nā ʻāpana koho apical Ca (TRPV5). I nā huaʻōlelo, he hoʻohaʻahaʻa i ka hoʻāʻo ʻana o Ca i loko o ka puʻuwai e hoʻonui i ka mea hoʻokele no ka reabsorption mai ka lumen o ka tubule o ka nephron.

Hoʻonui pū ʻo Thiazide diuretics Ca reabsorption me ka hoʻohana ʻana i kahi hana e hoʻohālikelike ai ʻo Na lāua ʻo Ca i nā pōkole proximal e pane aku ai i ka hōʻemi o ka hoʻoili ʻana o Na. ʻO ka mahele o kēia pane e hiki mai ma muli o ka hoʻonui o ka pae o ka hormone parathyroid.

ʻO ka hopena diuretic o ka diuret thiazide i ʻoi aku ka palupalu ma mua o ka loop diuretics, ulu ka ulu a hoʻolōʻihi, akā i ka lōʻihi.

Nā maʻi hoʻohālikelike i ka hoʻohana ʻana o ka diuret th thiazide

Thiazide diuretics aneʻi a hoʻohālikelike ʻia i kēia mau maʻi.

• Nā maʻi haipule
• ʻO kahi hopena pili i ka lāʻau lapaʻau,
• ʻO Renal hiki ʻole
• Lithium therapy,
• Hypokalemia
• E hōʻemi i ka maʻi diabetes.

Hoʻololi ʻo Thiazide diuretics i ka pale ʻana i ka waikū uric, ʻoiai ua hoʻokūkū lākou me ia no ka mea lawe, no laila, e like me lākou. e hoʻonui i nā pae waikela uric i ke koko . ^ E Ha yM. No laila, pono e hoʻohana ʻia me ka akahele i ka poʻe maʻi me ka gout a i ʻole hyperuricemia.

Hoʻohana mau ʻia ka diuretics thiazide paha kumu i ka hyperklycemia . ^ E Ha yM. Hiki ke hopena paha ʻo Thiazide diuretics e lilo ai i ka paʻakai ma ke kino ke malama nei i na kikoo o CA.

Hiki i ka Thiazide diuretics ke hōʻemi i ka pume plasenta a me ka hoʻopilikia i ka wī, no laila e pale ʻia i ka wā hāpai .

Nā hopena hopena o ka diuretics thiazide

Hoʻokomo ʻia ʻo Thiazide diuretics i kēia hopena:

• Haumakua,
• Hāpiha
• Hypokalemia (ka hōʻike ʻia o ke ʻano o kona hoʻomohala i lalo)
• Hyponatremia,
• Hypomagnesemia,
• Houloule,
• ʻO ka Hyperuricemia, ʻoiai he luhi ka gout. Ua emi iho ka liʻiliʻi o nā wahine ma mua o nā kāne
• ʻO ka huehuei huakini huelo: mual, anorexia, ʻeha, cholecystitis, pancreatitis, ʻeha o ka ʻōpū, constipation,
• Hāpopo. ʻO ka hoʻonui nui aʻe o ka protein cholesterol i ka 5-15% a me ka hoʻonui nui aʻe o ka pae haʻahaʻa haʻahaʻa haʻahaʻa lipoproteins (VLDL) a me triglycerides (TG). Ma keʻano holoʻokoʻa, liʻiliʻi ka liʻiliʻi o ka hoʻomohala ʻana i ka atherosclerosis,
• Hōʻalo i nā pūnaehana neʻe i waena (CNS): nāwaliwali, xantopsia, hoʻonui nui i ka momona, paresthesia. Anela
• Hoʻoulu ka uluʻana i 10% o nā kāne ma muli o ka kaohiʻana o ka nui o ka nui o ke kahe i loko o ke kino,
• Allergic hopena pili. Ua nānā ʻia ke alikaʻi ʻana me ka hui sulfonamide,
• Nui ka nānā ʻana o nā Photosensitization a me dermatitis, a paʻa pinepine loa i ka thrombocytopenia, hemolytic anemia a me ke ake ʻana o ka pancreatitis necrotizing.

Nā mīkini hana o ka hypokalemia

Thaizide diuretics i ʻike ʻia e kumu i ka hypokalemia.Nui nā hana no ka hoʻomohala ʻana o hypokalemia i ka wā e lawe ana i ka diuretics thiazide (i.e., e hoʻemi ana i ka kaohi o ka pāhana i loko o ka plasma):

Hoʻokomo i ka ʻōnaehana renin-angiotensin-ald testosterone ma muli o ka diuretic hypovolemia: pane ke kino i ka hoʻemi ʻana ma ke pae o ka nui o ka wai i loko o ke kino a hoʻomaka e hoʻoulu hou i ka aldosterone, ka mea e hoʻoulu ai i ka hana metabolite Na / K, e alakaʻi ana i ka nalowale o ka paʻakai. No kēia kumu, hoʻohana pinepine ʻia ka ACE inhibitors e pale i ka angiotensin 2 e hui pū me ka diuretics thiazide e hakakā i ka hypokalemia. ʻO ka hui kūpono o nā pehu e hiki ke hoʻokō i kēia pahuhopu.

ʻO ka emi ʻana o ke kao o K i ka wā i ka manawa o ka hoʻonui ʻana i ka hopena o ka urine e hoʻonui i ka kaila o K mai nā pūpū i ka wai. Ua nalowale ka paʻakai ma o nā pā pālolo e like me ROMK. Hoʻomaopopo kēia i ka laha passive.

ʻO ka Diuretics kahi hui kuʻuna o nā lāʻau lapaʻau i hoʻohana nui ʻia no ka mālama ʻana i ka hypertension arterial (AH). ʻOi loa ko lākou kaulana i ka USA a me nā ʻāina e ʻōlelo Pelekane. Ua hōʻike ʻia ka holomua hoʻomehana i ka mālamaʻana i ke hypertension i loko o nā hoʻokolohua nui i hoʻopaʻa ʻia i ka mea diuretics ke kumu a i ʻole ka hoʻohui ʻana i nā makahiki he nui o ka mālama antihypertensive. ʻO ke ʻano e pili ana i nā diuretics i kēia manawa Hoʻomau ka poʻe nui e noʻonoʻo iā lākou, me ka lāʻau lapaʻau antihypertensive o ka lālani mua. Manaʻo kekahi i nā diuretics e like me kekahi o nā hui like o nā lāʻau antihypertensive. Hoʻopau kekahi mau manaʻo e noʻonoʻo iā lākou i ke ʻano o ka lā i hala. Me ka pōmaikaʻi pono ʻole - ka hopena hypotensive i hoʻōla ʻia, ka maʻalahi o ka make ʻana, ke kumukūʻai haʻahaʻa, nui nā diuretics he nui nā pōʻino e pili ana i ka paleʻana o ka electrolyte impaired, lipid a me ka hoʻoneʻe pākia a me ka hana o CAS.

ʻEkolu mau pūʻulu o ka diuretics i ʻike ʻia i ʻokoʻa i ka hoʻolālā kemika a me ka hoʻokano ʻana i ka hana ma ka nephron.

• ʻōpili ʻaia
• kūwaha hoʻi
• Diuretics pākoleka-sparing.

ʻO ka hopena lāʻau lapaʻau o ka thiazide a me ka diuretics like-thiazide e maopopo ana i ka pae o na hoʻoheheʻe kūloko diuretics loop - ma ka pae piʻi piʻi ʻO Henle, pāpaʻi-kālai - i ka nui loa na keʻena mamao na hoʻoheheʻe kūloko.

ʻO nā diuretics āpau, koe wale nō ʻo spironolactone, "hana" ma ka papa e kū ana i ka lumen nephron. No ka neʻe ʻana o ka diuretics i ke koko i loko o kahi i hoʻopaʻa ʻia i ka protein, ʻaʻole lākou e hele i ka kāni glomerular, akā hiki i ko lākou wahi e hana ai me ka hūnā ikaika i nā ʻāpana kūpono o ka nephron e ka epithelium. ʻO ka hiki ʻole o ka epitheli renal e huna i kahi a i ʻole kekahi o nā hui o ka diuretics i nā kūlana pathological (me ka hoʻohālike, me ka acidosis) ka mea nui a hoʻoholo i kā lākou koho.

Loaʻa a me nā huaʻinoʻole o nā lāʻau lapaʻau

Ua ʻike ʻia ka hoʻohana ʻana i nā lāʻau lapaʻau no ka mālama ʻana i ka maʻi hypertension no ʻoi aku ma mua o 70 mau makahiki, i loko o kēia manawa he mea maopopo loa ka hana o kā lākou hana a me nā hiʻohiʻona o ke koho. Loaʻa nā pono o ka diuret thiazide:

• ka hana maʻamau
• ka wikiwiki wikiwiki o nā hualoaʻa (30 - 60 mau minuke),
• lōʻihi ka lōʻihi o nā hōʻike lōʻihi (a hiki i 11 mau hola),
• mai kumu i alkalization a i ʻole ka acidization o ke koko,
• pale i nā maʻi koko cerebral i ka hypertension.

ʻO nā poʻomanaʻo nui o ka hoʻohana ʻana i ka diuretics o kēia hui:

• ʻO hypokalemia a me hypomagnesemia, ka mea e hoʻonāukiuki i ka hoʻonāukiuki i ke ʻano o nā kuʻikahi.
• mālama uic acid a me ka hoʻōho o ka gout,
• hoʻonui i ke kō koko a me ka hoʻokaʻawale i ka maʻi diabetes,
• maʻalea, ka lolo, ka palupalu holoʻokoʻa.
• lōkohu
• pilikia kino.

Nā hōʻailona no ka koho

Hiki ke hoʻohanaʻia nā Thiazide diuretics no kēlā mau maʻi:

• ʻO ka edema me ka holo o ke kaʻe, cirrhosis o ka pūpū, ka maʻi o ka pūpū,
• primert and hypertension kiʻekiʻe,
• glaucoma
• insipidus maʻi
• ka waiho ʻana o ka wai i ka wā o ka momona, ma mua o ke kāne.
• ka ʻōpū ʻana o nā wāwae me ka thrombosis,
• ka ʻohi ʻana o nā oxalates i loko o nā pūpū.

E nānā i ka wikiō e pili ana i ka hana a diuretics a i ʻole diuretics:

Loaʻa nā hopena maikaʻi loa

ʻO ka lawe ʻana i ka diuretics e hiki ai i ka nāwaliwali nui o ka nāwaliwali, huakaʻi, kaʻeleʻele i nā maka, ka ʻōpū a me ka maʻi ʻana, nā ʻōpū o ka ʻōpū, ke nānā ʻana i ka platelets, nā keʻena koko keʻokeʻo, ka hoʻonui ʻana i ka waika uric, ka calcium.

I ka pule mua o ka hoʻohana ʻana i ka thiazides, hiki i ka wikiwiki ke ʻano a me ka neʻe ʻana o ka nānā ʻana, no laila, ʻaʻole ia e manaʻo e neʻe i nā kaʻa a i ʻole me ka hana paʻakikī.

I mea e pale ai i ka nalowale nui o ka paʻakai, ʻōlelo pinepine ʻia nā lāʻau me nā ʻikepili - Panangin, Asparkam, Potassium normin, Caliposis. Pono ka papa ʻai i ka nui o nā lau ʻai, nā hua a me nā wai o lākou mai ia lākou, ka meli, nā apricots maloʻo, nā huaʻai a me nā lemona he pono.

ʻO nā pono a me nā hōʻino o diuretics

Hoʻohana ʻia nā mea maikaʻi o ka diuretics e nā mea hoʻokūkū (a ʻo ʻoe a me aʻu ʻaʻole kekahi mea ʻē aʻe, ma hope o nā mea āpau). Ke lawe nei i nā diuretics ma mua o ka hoʻokūkū, ʻoi aku lākou me ka wikiwiki e hoʻoiho i ka kaumaha "nui". Hoʻohana pū ka wahine i kēia mau lāʻau lapaʻau no ka luhi kaumaha. Hoʻomaʻumua ka mea hoʻomaʻemaʻe kino i ke kino i mea e hoʻopololei ai i nā wai a me nā ʻōpū e ʻike nui ʻia.

Akā, e like me nā mea āpau, aia nā ʻaoʻao ʻelua i ka ʻāpana a me nā pōmaikaʻi, hiki ke hoʻopilikia ʻia ka diuretics.

• Me ka urine, ʻaʻole wale nā ​​paʻakai sodium e ʻoki ʻia mai ke kino, akā, ʻo nā mea ʻono maikaʻi hoʻi, no ka laʻana, pākana, ka hemahema e alakaʻi ai i ka wikiwiki wikiwiki a me ka nalowale o ka ikaika.
• Nalo ke haʻalele i ke kūlohelohe kūlohelohe, kahi i hāʻawi ʻia ma ka lawe ʻana i nā paʻakai,
• Hiki i ka uritation wikiwiki ke alakaʻi i ka hana hiamoe,
• Hoʻonui ka Diuretics i ka pae o ka kolamu "kino" i loko o ke koko,
• Hiki i nā lāʻau diuretic ke hana i ka dysfunction reproduction i nā kāne.

I mea e hōʻalo ai i nā hopena maikaʻi ʻole o ka diuretics ma ke kino, ke aʻo aku nei au ʻoe iā ʻoe e hoʻōki pono iā ʻoe iho, akā e kamaʻilio pū aku i ke kauka a e noʻonoʻo pono i nā diuretics e kūpono iā ʻoe, pehea e hoʻohana ai, i hiki iā ʻoe ke hoʻohui pū ai e hoʻokō i kahi hopena maikaʻi ʻole me ka hopena ʻino.

Pehea e hana ai ka diuret thiazide?

He hopena ka hopena o ka diuret Thiazide i loko o ka epithelium lining i nā tubal distal o ka nephron. Loaʻa ka ciumium Sodium i ka hana osmotic kiʻekiʻe, ke alakaʻi nei i ka hoʻomohala ʻana o ka edema, me ka ʻano o ka hypertension ("huki pū ʻia ka paʻakai me ka wai"). ʻO Thiazide a me thiazide-like diuretics inhibit (block) i nā kaola o nā protein - nā kihi, kahi kuʻuna no ka lawe ʻana i nā sodium a me nā anine klorine. No kēia kumu, ʻo ko lākou inoa ʻelua he saluretics ("excreting salts"). Ua hoʻemi ka nui o ka sodium, ua emi iho ka osmolarity o ka plasma - ke kaulike a edema a me ka hoʻonaninua koʻikoʻi i ke kahe koko.

Hoʻopili i nā hana natriuretic, ʻo ka diuretics thiazide he haʻahaʻa haʻahaʻa e pale i ka hoʻoneʻe carbonic anhydrase. Hōʻike ʻia kēia hopena e ka hōʻemi o nā mea o nā anion phosphate a me bicarbonate. ʻO ka hoʻohana lōʻihi ʻana i nā lāʻau lapaʻau o ka hui diuretic thiazide e alakaʻi i ka hoʻomahaʻana i ka māhele o ke kino ma ka nui o ka maʻi o ka maʻi (ʻoi ka pale). No laila, hoʻohana nā poʻe cardiologists i nā diuretics like-thiazide i ka mālama ʻana o hypertension i hui pū me nā lāʻau antihypertensive kumu.

ʻO ka hopena ma ka reabsorption kalaiʻa (hoʻohuli i ka hoʻihoʻi ʻana i ke koko) e hoʻōla ai i ka lāʻau lapaʻau me ka osteoporosis concomitant, calcium nephrolithiasis. Ke manaʻoʻiʻo ia ʻo ka hopena ma nā kahawai e lawe ana i nā cation calcium e hōʻemi ana i ka remodeling vascular.

ʻO nā hanana ʻino e pili ana i ka hoʻohana ʻana i nā lāʻau lapaʻau e pili pū ana me ka hopena uricemic (ka piʻi nui ʻana o ka uric acid), ka hopena i ka metabolism o ka glucose (hyperglycemia).Hiki ke hoʻololi ʻia i ka haku himene serum lipid (ʻo ka nui o ka lipoproteins haʻahaʻa haʻahaʻa a hoʻonui i ka cholesterol).

ʻO nā diuretics like-Thiazide ke kī like o nā pūnehana noi, ma kahi o ka pale ʻana i ka hana o ka enzyme anicdrase carbonic. ʻO nā hopena ʻokoʻa ka like. Loaʻa ka ʻokoʻa i ka ʻokoʻa i ka hoʻolālā kemika, like nā ʻano hana.

ACE paleai

No ka hoʻomau mau ʻana o nā hōʻike o ka hypertension, hoʻohana ʻia nā blockers angiotensin-hoʻohuli i ka hoʻokūkū (ACE), ka mea e hoʻoulu ai i ka hana o ka angiotensin. Ma ka hoʻemi ʻana i ke kao o ka angiotensin, e hoʻopiʻi ka huaʻai adrenal i kahi aldoster like me ka hormone, e paʻa ai i ka sodium a me ka wai i loko o ke kino. Loaʻa ka Vasodilation, hoʻopiʻi ka nui o nā meaʻono a me nā paʻakai, e hōʻike ʻia kahi hopena hypotonic.

Nā mea ʻona e pāpā aku ai i ka ACE:

• Enalapril
• Perindopril,
• Quinapril,
• Fosinopril
• Paola
• ʻO Ramipril.

ʻO nā pōʻino ʻole o ka inhibitors ka mea e hiki ai ke hoʻolohi i ka paʻakai pākē a hoʻopau i ka hana pono. ʻImi ʻia nā hopena o ke noi ma mua o ʻelua mau pule ma hope o ka hoʻonā ʻia ʻana.

ʻAnoʻeha Hoʻokuʻu Mea Hōʻehu ʻo Angiotensin (ARBs)

Hōʻalo lākou i ka synthesis o renin, ka mea e hoʻoulu ai i ka hoʻololi o ka angiotensin, kahi e hoʻopaʻa ai i ka hoʻopaʻa ʻana o nā pā o nā kahe koko. A kuhikuhi ʻia nā ARBs inā ua hoʻokūpaʻa ʻia nā pale ʻole ACE. ʻOkoʻa ke ʻano o nā ʻano hana o kā lākou biochemical, akā ke like ka pahuhopu - e hōʻemi i nā hopena o ka angiotensin a me aldosterone.

Ua kapa ʻia kēia hui i nā sartans ma ka hope o nā inoa o nā mea ikaika:

Ma ka hopena o nā diuretics ka hopena hypotonic me ke kahakaha, ua hoʻohālikelike ʻia i ka hui ʻana me ka hoʻohana ʻana i nā papa ʻē aʻe no ka hypertension ma ka maʻi mellitus.

1. Hoʻopili maikaʻi ʻia ka Loop diuretics (furosemide, lasex) me nā mea paʻa o ka ACE, ʻaʻole i pili i ke kiʻekiʻe o ke kō, ka lipids, a he kūpono no ke kaʻina pōkole e hoʻopau i ka ʻāʻī nui o nā kiko. Hoʻokumu ka hoʻohana ʻole ʻana i ka paʻahana, ka mea e hoʻonāukiuki i ka hoʻonui ʻana o ka hypokalemia a me ka arrhythmia cardiac.
2. Ma muli o ka hopena diuretic ka hopena, ʻaʻole i hoʻonāukiuki ʻia ka diuretics like-thiazide (indapamide) i ka pae o ka glucose, nā momona momona, nā pae momona, a ʻaʻole e hoʻopilikia i ka hana kūlohelohe o nā keiki.
3. Thaizide diuretics (hypothiazide) i nā lā me nā lā he nui a keu ʻo 50 mg hiki ke hoʻonui i ka glucose a me ka cholesterol. Ua kuhikuhi ʻia lākou me ka mālama aka i nā liʻiliʻi liʻiliʻi ma muli o ka ulu ʻana o ka maikaʻi ʻole o ka pilikia a me ka gout.
4. ʻAʻole kōkua ʻia nā mea kanu pālua (Veroshpiron) no ka hoʻohana ʻana ma ka mellitus type type 2, i hele pū ʻia e nā hana renal impaired.

Nā māka hua Beta

Ua helu ʻia he nui o nā lāʻau e hoʻōki i ka hoʻoulu ʻana o ka adrenoreceptors e ka adrenaline a me ka norepinephrine i kuhikuhi mua ʻia no ka mālama ʻana i ischemia, cardiosclerosis, ka huhū o ka naʻau. Me ka hyperglycemia, ua koho ʻia nā papa no ka hypertension me ka hopena vasodilating hou:

Nā antagonist calcium

Kūleʻa pākoki kalepona - kahi hui o nā lāʻau lapaʻau e hōʻemi i ka neʻe ʻana o nā calcium calcium. Hoʻomaha a hoʻonui i nā paia o nā kīʻaha koko, nā ʻalunu, nā pūnaa mākeke palalike. Ka mahele ʻokoʻa i nā hui:

1. Verapamil, diltiazem. Hoʻopilikia i ka hana a myocardium a me nā puʻuwai puʻuwai, e hōʻemi i ka helu o ka puʻuwai. Hoʻohana ʻia ka hoʻohana ʻana me ka beta-blockers.
2. Nā hua o nā dihydropyridine - nifedipine, verapamil, nimodipine, amlodipine. Ua hoʻomaha lākou i nā paia o nā pūnaka hana pono, hoʻonui i ka nui o ka puʻuwai.

ʻAʻohe o ka calcium antagonist e hoʻopili i ka kāloe, ka hana lipid metabolism. I ka manawa e hoʻohana ai i ka lāʻau lapaʻau no ka paipai ʻana, he ʻoluʻolu ke ʻano type like 2, akā he nui nā contraindications. Hoʻopiliʻia ka Nifedipine ma ka angina pectoris, puʻuwai a me nā hina ʻole, kūpono no ka hoʻomaha ʻana o nā pōʻino. Hiki iā Amlodipine ke hooulu i ka māla.He hopena akahai ʻo Verapamil i ka hana o nā kuli, akā hiki iā ia ke hana i nā bronchodilators.

ʻO ke ʻano pilikino

Hoʻohui kekahi o nā lāʻau Antihypertensive me kēlā me kēia, i koho ʻia e like me nā maʻi e hui pū ana, nā lāʻau i lawe ʻia. ʻO ka maʻi hypertension, ka mea i hoʻopili ʻia e ka maʻi diabetes maʻi intracellular metabolism, e hoʻokūkū i nā ʻano like ʻole kūʻokoʻa.

Ma mua o ka hoʻohana ʻana, pono ʻoe e aʻo i ka papa inoa o nā hopena ʻaoʻao, nā ʻano o ka hoʻopau ʻana iā lākou.

Ke lawe nei, mālama ʻia ke kumukania o ke koko. I ka manawa like, ka nui o ka hemoglobin glycated, kolamu, triglycerides, wikiwiki i ka glucose a ma hope o ka ʻai ʻia. Pono nā hemahema mai ka pae ʻokoʻa e pono ai ka loli o nā lāʻau lapaʻau.

Nā diopetics Loop

Hoʻomaopopo ʻia ʻekolu mau lāʻau ʻo ka diuretics loop - furosemide, acidacacliclic a me ka bumetanide. Loaʻa i ka diuretics Loop ka hopena saluretic ikaika ma muli o ka pāpā ʻana i ka pūnaehana ma ka Ma2 + / K + / Cl-co-transport i ka ʻeke o ka puʻu Henle. ʻO ka hōʻailona nui no kā lākou koho i ka hypertension ʻo kōpono kūwaho ʻaina nā mālamuhala thiazide maikaʻi ʻole. ʻO ke koho ʻana o ka diuretics loop i nā mea maʻi me ka hypertension uncomplicated ʻaʻohe mea nui ma muli o ka manawa pōkole o kā lākou hana a me ka huʻunuʻu. ʻO nā hopena āpau o nā maʻi o ka diuretika thiazide, ʻaʻole i emi iki i ka diuretics loop, a loaʻa nō hoʻi ia ka hopena ototoxic.

ʻO ka lāʻau lapaʻau kaulana loa mai ka pūʻulu o ka diuretics loop huluhula He hana ikaika, akā he mau manawa pōkole (4-6 mau hola), no laila e lawe ʻia ʻelua i kēlā me kēia lā. I ka hypertension me ka maikaʻi ʻole o ka renal ka koho ʻana, koho ʻia ka nui o ka furosemide i kēlā me kēia, e like me ke kānāwai o ke kānalua i nā pilala (40, 80, 160, 320 mg).

Diuretics pākakai-sparing

ʻO kēia pūʻulu o nā lāʻau lapaʻau spironolactone (Veroshpiron) amiloride a triamteren ka loaʻa ʻana o kahi waiwai kōkua mua ma ka hypertension. ʻO ka Triamteren a me ka amiloride he inhibitors pololei o ka huna ʻia o ka potassium huna i ka puna distal a loaʻa kahi hopena diuretic a me ka hopena hypotensive. Hoʻohana ʻia lākou e hui pū me ka diuret thiazide e pale ai i ka hypokalemia. Manaʻo nā kauka i ka lāʻau lapaʻau triampur (hui pūʻana me 25 mg o ka hypothiazide a me 50 mg o ka triamteren). ʻOi aku ka maikaʻi loa o ka lāʻau moduretic, nā 50 mg o hypothiazide a me 5 mg o ka amiloride. ʻO ka Triamteren a me amiloride e contraindicated me ka hana ʻole o ka aʻalolo ma muli o ka hopena nui o ka hyperkalemia. Ua ʻike ʻia e hiki i ka hoʻohana pū ʻana o ka triamteren a me indomethacin i hiki ai ke hoʻihoʻi hou ʻole a me ka hana ʻole i ke aʻalolo. Ke mālama nei me ka amiloride, kēlā mau hopena like me ka nausea, hōʻuluʻulu, a me nā ʻulaʻā i kekahi manawa i kekahi manawa.

Ka hana o ka hana o ka spironolactone e moe ana i ka antagonism hoʻokūkū me ka aldosterone, ka analogue hoʻokūkū o ia mea. I nā haʻahaʻa nui (100 mg i kēlā me kēia lā) spironolactone loaʻa kahi hopena diuretic a me hypotensive. Eia nō naʻe, ʻaʻole ka manaʻo kūʻokoʻa o spironolactone e pili ana i ka mālama ʻana i ka maʻi hypertension, no ka mea ʻo ka hoʻokō ʻana o kona manawa lōʻihi i ke ʻano o ka hoʻomohala ʻana i ka hopena o ka hopena o ka hormonal (gynecomastia i nā kāne a me ka amenorrhea i nā kāne). Ke lawe nei i nā haʻahaʻa haʻahaʻa (50 mg i kēlā me kēia lā), ke emi nei ka wikiwiki o nā hopena ʻaoʻao, akā naʻe, nāwaliwali ʻelua o ka diuretic a me nā antihypertensive.

He aha nā diuretics i kēia manawa e hana i ka poʻe maʻi me ka hypertension?

ʻO nā lāʻau lapaʻau nui o kēia papa i ka mālama ʻana i ka hypertension ʻo thiazides a me diuretics like thiazide-like. ʻO ka lāʻau maʻamau loa e pili ana i ka hydrochlorothiazide, chlortalidone a me ka indapamide (Arifon-retard).

Hiki ke hoʻohana ʻia ʻo Thiazide diuretics ma ke ʻano he nui i nā maʻi, i ʻole e hoʻopuni a me ka paʻakikī ʻo AH. ʻO nā kūlana kulekele i mea e hoʻohana ʻia ai ka diuretics:

• Haki puʻuwai
• Naʻi maʻi mellitus
• ʻO ka hypertension Systolic
• Kākoʻo o nā ʻōkuhi pinepine
• Kahaiʻālua
• Maʻi maʻi cerebrovascular
• Mamua
• Kōlei ʻōleʻele

Hoʻohana ʻia ka hoʻohana ʻana o thiazides he contraindication wale nō hapai a hypokalemia . ^ E Ha yM. Pono ʻia ka mālama ʻana i ka wā e hoʻohana ʻia ai i nā mea maʻi me ka gout, dyslipidemia, diabetes mellitus a me nā pilikia ʻole o ka renal.

ʻO wai ka wai mai kēia pūʻulu ʻo ia ka maikaʻi?

ʻO ka makemake nui i ka diuretic antihypertensive, he mau hopena diuretic nāwaliwali a me kahi hopena vasoprotective i haʻi ʻia, i kēia manawa ke maopopo a kūpono Arifon Retard (indapamide). ʻAʻole hopohopo ʻo Metabolic e pili ana i ka diuret thiazide, ʻaʻole i hopohopo iā Arifon-retard, kahi ma kahi lāʻau i hōʻemi ʻia i ka 1.5 mg ʻaʻole i weliweli i nā ʻāpana o ka lipid me ka ʻaila metabolism a no laila ʻoi aku ka makemake i ka wā e koho ai i kahi diuretic. No nā mea maʻi me ka hypertension i hui pū me ka maʻi diabetes mellitus, pono ke hoʻohana ʻana o Arifon-retard no ka mālama hui ʻana, ʻo ia hoʻi, hāʻawi ʻia i ka pae haʻahaʻa haʻahaʻa o ka hoʻohaʻahaʻa i ke koko (130/80) a me ke kūpaʻa metabolic.

I kēia lā, ʻaʻohe ʻano o ka helu o nā diuretics, kahi e noʻonoʻo ai i nā mea āpau o nā hana o kēia mau ʻano lāʻau. No laila, hiki i nā māhele ke hoʻokaʻawale e:

• kaila ʻona
• ke kahua
• ka hana o ka hana
• ikaika o ka hana
• mau hopena hopena, ke ʻano
• hala ʻike
• nā hopena ʻaoʻao.

Ka helu ʻano mua o ka diuretics ma muli o nā ʻano like ʻole i ka papa kemana o nā lāʻau lapaʻau. A laila aia kekahi hoʻāʻo e hoʻokaʻawale i nā ʻano diuretics e like me ke ʻano o kā lākou hopena i ka lolo. Eia nō naʻe, aia kekahi mau diuretics he hopena extrarenal. ʻO ka hoʻāʻo ʻana e hoʻokaʻawale i nā diuretics e like me ke ʻāpana o ka nephron a lākou e hoʻopilikia ai, ʻaʻole nō ka hopena, ʻo ka mea make osmotic, ethacrine acid, furosemide, Xanthines a me nā mea ʻē aʻe ʻaʻole e hana i kahi ʻāpana kūikawā o ka nephron, akā i loko o kona lōʻihi. I ka pilina me nā hiʻohiʻona o ka diuretics, ka helu ʻana o ka hana a ka mea e hoʻomaʻamaʻa loa ai.

Ke mālama nei i ka mea maʻi, mai kahi ʻanoʻike kauka, ʻo ka helu ʻana i nā diuretics ʻaʻole mea koʻikoʻi e like me ka lōʻihi o ka hōʻike, ka nui o ka hoʻomaka ʻana o ka hopena, a me ka ikaika o ka hana.

Hoʻomākaukau a me kā lākou hoʻohana

ʻO ka lāʻau lapaʻau nui i waena o ka diuret thiazide ʻo ka chlortiazide (hydrochlorothiazide). ʻO nā lāʻau like Thiazide e like me Chlortalidone, Indapamide, Xipamide. I kēia manawa, ua hoʻopaʻa inoa ʻia nā mea hoʻohana lāʻau ʻikepili ("generics").

Nā hōʻailona no ka hoʻohana ʻana i nā saluretics:

• ʻO ka mālama ʻana i ka maʻi edematous me ka maʻi nephrotic. Haʻahaʻa ka liʻiliʻi. Hoʻohana ka hoʻohana pono ʻana i ka wā i hoʻoholo ʻia ai he ʻāpana o ʻelua -, i kekahi manawa ʻekolu mau wae diuretic therapy. ʻO ka hemahema o ka hana i ka wā o nā hoʻololi nephrotic e wehewehe ʻia e kekahi mea e ae: hypoproteinemia a me ka edema oncotically kumu. Pono e hoʻoiho ʻia ʻo Thiazide diuretics i ka manaʻo e hiki ke hoʻololi i ka electrolyte hoʻololi - hypokalemia, hyponatremia.
• ʻO Edema me kaʻeha pale cirrhotic. Therapy ma ke ʻano he ʻāpana o ka hana diuretic i hoʻohui ʻia.
• He maʻi haole. Konoia ia e hoʻohana e like monotherapy kūikawā no ka haʻahaʻa haʻahaʻa (2 degere). ʻO ka koho i ke aloha i nā lāʻau like-like thiazide i ka mālama ʻana i ke hypertension e lawe ʻia e nā cardiologists ma muli o ka hopena lōʻihi, ka wikiwiki wikiwiki o ka hoʻemi ʻana o ke kaomi. Hāʻawi ʻia kahi regimen haʻahaʻa i kahi kaohi o ke koko, ke hoʻonui ʻia nā kaila me ka hoʻonui ʻana wale.
• Hoʻopilikia o ka puʻuwai hōʻeha e like me nā ʻōlelo ʻana a me ka ʻōlelo ʻana ma ka Europa a me ka Lūkini e koi ai i ka pono o ka saluretics Loaʻa iā Chlortalidone kahi hopena antihypertensive no nā lā 3. Hoʻokomo maikaʻi ka Induramide a me thiazide diuretics no 24 mau hola. ʻO ka hōʻemi ʻana i ka hopena o ka hyperkalemia. Hāʻawi kēia iā ʻoe e hoʻohana iā lākou i kēlā me kēia lā, a i ʻole ka liʻiliʻi.Eia kekahi, ʻoi aku ka hopena hoʻomaha ma nā pakanui uaua kikoʻī e pili ana i ka hoʻohana ʻana i nā lāʻau no ka hypertension a me ka huhū o ka naʻau.

Nā hopena ʻaoʻao a me nā contraindications

ʻO nā hopena ʻeha e loaʻa ai i nā lāʻau lapaʻau ma kēia pūʻulu e pili ana i ka hilahila metabolab a me nā mea hoʻonā electrolyte ma muli o ka hana o ka hana.

1. Hypokalemia a me kāna hopena arrhythmogenic a hiki i asystole. Pono ia i ka hōʻemi ʻana i ka lāʻau lapaʻau a me ka hoʻoponopono ʻana i ka ʻikepili serum kalima.
2. Hyponatremia.
3. Hoʻololi nā hoʻololi atherogen i ka plasma me ka makemake o ka thrombosis. Hoʻolālā ʻia e ka lawe ʻana i nā statins.
4. ʻO ka Hyperuricemia me ka hoʻomohala ʻana i ka hōʻiliʻili o ka maʻi gouty a i ʻole me ka pōʻino o ka pōpoki e ka urate. ʻO ka wehe ʻana i nā lāʻau lapaʻau ke kumu o kahi paʻa o kēia kaʻina hana.
5. Ka hoʻolaʻaʻana i nā haʻamola kalaiwa hoʻōla, ʻoi aku ka wā i hoʻohana pū ʻia me nā beta-blockers.

Mai nā hopena hopena o nā lāʻau lapaʻau, hoʻopaʻa inoa ʻia kahi papa o nā contraindications:

• gouty arthritis, nephropathy,
• hypokalemia
• hoʻemi ʻia ka sodium
• ʻae ʻia ka hoʻohana ʻana (ʻo ka hoʻohana ʻana iā Indapamide e like me ka lāʻau liʻiliʻi e aʻo ʻia ana me ka hopena ma ka pūpū me ka maikaʻi ʻole), ʻoiai e lawe ana ka Hypothiazide ma ke ʻano o ka lāʻau hui (me ka ʻole o ACE inhibitors).
• hopena kūlohelohe.

ʻO Thiazides a me kā lākou ʻano i hana

Manaʻo ʻia ʻo Thiazide diuretics i nā lāʻau lapaʻau o ke kaha ikaika o ka ikaika, ka hopena o lākou e loaʻa ma hope o nā hola 1-3 a kū mau no 12 mau hola. Hana ka hana o ka diuret thiazide e pili ana i nā ʻōpala e kokoke kokoke ana i ka hana, ma muli o ke ʻano o ke kaʻi ʻana o ka sodium a me ka chlorine a me kā lākou hoʻonui ʻana me ka urine. Eia kekahi, he hopena diuretic e like me ka diuretic lowers output me ka calcium urine a hoʻēmi i ka hoʻokumu ʻana o ka waikika uric.

Nā hōʻailona no ka hoʻohana ʻana o ka diuret th thiazide

Hoʻohana ʻo Thiazide diuretics e mālama i nā ʻōkuhi i lalo:

• Ka mea huehue, i hana ʻia ma muli o ka maʻi ʻōlima, kahi hōʻailona i ka hōʻino ʻia o ka palaki o ka wai-paʻakai. Eia nō naʻe, he haʻahaʻa ka ulu ʻana o ka diuret thiazide no ka mālama ʻana i kēia maʻi.
• ʻO Edema ma o ka cirrhosis. Hoʻohana pinepine e launa me nā diuretics ʻē aʻe.
• Ke koko kiʻekiʻe.
• Ka huehue a paʻakikī ka hopena.

Nā ʻāpana hoʻoikaika

Hoʻohana ʻia ka Thaizide diuretics e mālama i ka nui o nā maʻi. Hoʻohana pinepine ʻia, nā lāʻau lapaʻau, nā ʻāpana nui o ka hydrochlorothiazide a me ka chlortiazide. Hoʻomaka lākou e hana ma hope o kekahi mau hola, a ua ʻike ʻia kā lākou ʻike mana loa he 3-4 mau hola ma hope o ka hoʻokele ʻana. Hana ʻia ka hana ma kahi o 11-13 hola.

"Kahikiwaiwai"

No loko o ka diuretics kūloko a hoʻohana ʻia no ka mālama ʻana i ke koko koko kiʻekiʻe, ke kuhi ʻana i ka naʻau, cirrhosis a no ka pale ʻana i nā pōhaku. Hoʻohana ʻia ka lāʻau lapaʻau ma ke ʻano he mau papa e pono ai e hoʻopau ʻia ma hope o kahi pāʻina i ke kakahiaka. No ka mālamaʻana i ke koko koko nui, ʻōlelo pololei nā kauka i ka inu 1 papa i hoʻokahi lā i ka lā. I nā hihia o ka edema, pono ʻoe e inu i nā papa he 1-4. He nui ia nā hopena hopena, e like me ka nausea a me ka hoʻopuʻi, nā alapiʻi, nā arrhythmias, a me nā hopena alia. ʻAʻole ʻōlelo nā kauka i ka inu ʻana ʻo "Hydrochlorothiazide" i ka wā hāpai a ʻo ka wā e hāpai ai ka pēpē, a me nā ʻelemakule hoʻi. He mea nui ia e hoʻomaopopo i ka wā e hoʻohana ai i nā lāʻau lapaʻau, ʻaʻole pono ʻoe i ka lā no ka manawa lōʻihi, ʻoiai ʻo ka lāʻau lapaʻau ke kumu i ka ulu ʻana o ka ʻili o ka ʻili o ka lā.

E hoʻohana i kahi lāʻau lapaʻau no ka mālamaʻana i ke koko kiʻekiʻe. E inu ka wai i ka lāʻau i ke kakahiaka, me ka mea ʻole o ka ʻai, ma ka pākaukau 1 mau manawa i ka lā.Hoʻokomo ʻo Indapamide i kēlā me kēia hopena: ka ʻeha, hoʻonui i ka huhū, ke kaumaha, nā ʻōpū, ke kāʻei. Ma kahi o kahi overdose, hiki i ka mea maʻi ke loaʻa i ka nausea, ka luaʻi, ke poʻo a me ke kaumaha, nā momona a me ka haunaele. E hōʻoluʻolu i nā hōʻailona o ka pā overdose, pono ʻoe e holoi i kou ʻōpū a inu i ka waiwa e pono ai i ke charcoal hoʻōla ʻia. ʻAʻole pono ʻoe e lawe i ka lāʻau lapaʻau i ka wā o ka hāpai a me ka umauma.

He thiazide lōʻihi, hana ka hana a ka mea e manaʻo nei e hoʻopau i ka potassium a me ka magnesium i loko o ka urine. Hoʻohana ʻia ia e hōʻemi i ka hoʻokaumaha ʻana a hōʻemi i ka puhi ʻana o nā ʻano like ʻole. No ka mālamaʻana i ka puffiness, ʻoi ʻia e hoʻohana i ka lāʻau lapaʻau 1-2 papa 1 manawa i ka lā. Ma hope o ka emi ʻana o ka pā ʻana, e hoʻemi ʻia ka lāʻau ʻona. E inu i kahi lāʻau lapaʻau e hoʻohaʻahaʻa i ka pona ma ke kau mua ʻana i ka lā hoʻokahi. ʻO "Clopamide" he nui nā hopena o ka hoʻopiʻi: ka hoʻemi ʻana o ke kōpaʻa o ka sodium a me ka paʻakai i loko o ke koko, e luaʻi ana, kīwī, a me nā māka. Hoʻohana ʻia ia e hoʻohana ai i ka wā hāpai a me ka umauma, akā pono ʻoe e inu i ka lāʻau lapaʻau me ka mālama aka a hiki wale i ka hopena i manaʻo ʻia ma mua o ka hopena o ke kūkulu ʻana i nā pathologies i ka pūpū.

ʻO nā diuretics, a i ʻole diuretics, nā mea e hoʻonui ai i ka excretion o ka urine mai loko mai o ke kino a hōʻemi i ke kahe i nā mea momona i loko o nā ʻāpana a me nā puʻu serous o ke kino. ʻO ka hoʻonui nui o ka urination i kumu e ka diuretics e pili ana me ko lākou hopena kikoʻī ma luna o nā keiki, ka mea nui i ka pale ʻana i ka reabsorption o nā iʻa sodium i loko o nā tubula o ka renal, i hui pū ʻia e ka hoʻemi ʻana i ka reabsorption wai. Hoʻokani ʻia kahi kuleana liʻiliʻi e ka filtration i hoʻonui ʻia i loko o ka glomeruli.

Hōʻike ʻia ka diuretics e nā hui penei:

a) diuretics "loop" a hana i ka māhele cortical o ka piko o Henle,

b) pākuhi pale-potasi,

He ʻokoʻa nā hopena diuretics e pili ana i ka hoʻokumu ʻana i ka urine, ka mea i hilinaʻi i ko lākou mau physicochemical properties, ka hana o ka hana a me kona wahi (nā ʻāpana ʻokoʻa o ka nephron).

ʻO ka mana ikaika loa o nā diuretics e kū nei he "loopback". Ma o kā lākou ulu waiwai, lākou ka huaʻala o ka sulfamoylanthranilic a me dichlorophenoxyacetic acid (furosemide, bumetanide, ethacrylic acid, etc.). Hoʻopuka ka diuretics Loop ma nā wahi piʻi o ka nephron loop (Henle loop) a hoʻoneʻe nui i ka reabsorption o ka chlorine a me ka sodium sodium, a ua hoʻonui hou ʻia nā kūmole me ka nui.

Hoʻopuka maikaʻi loa nā diuretics i ka thiazides - kahi huaʻai o benzothiadiazine (hydrochlorothiazide, cyclopentiazide, etc.). Hoʻonohonoho ka hopena i ka nui o ke kao cortical o ka nephron loop, kahi e pani ʻia ai ka reabsorption o nā cation (sodium a me ka potassium). Hoʻohui lākou iā lākou e ka hypokalemia, pākē kekahi.

Hoʻohana ʻia nā ʻelua diuretics a me benzothiadiazines i ka mālama ʻana i ke hypertension a me ka pohō o ka puʻuwai naʻau. E hoʻonui i nā diuresis, e hōʻemi ana lākou i ka BCC, kēlā, e hoʻi ka venous i ka puʻuwai a me ka ukana ma ka myocardium, e hōʻemi ana i ka ʻāʻī ma loko o ke akea. ʻO Thiazides, ma kahi iki, hoʻomaha pololei i ka paia vascular: nā kaʻina metabolic i loko o nā membran cell of hoʻololi i ka arterioles, inā paha, e emi ana ka ʻike o nā kaomi sodium, e alakaʻi ana i ka hōʻalo ʻana a me kahi hoʻēmi i ka pale kūloko o peripheral. Ma lalo o ka hopena o ka thiazides, e loli ka nui o ka hoʻololi ʻana i ka ʻōnaehana vascular, kaomi ʻana o ka pressor i nā vasoconstrictor mau mea (adrenaline, etc.)

Hoʻonui ka paʻakai paʻakai paʻakai i ka hoʻokuʻu ana i nā kī ʻana o ka sodium, akā i ka manawa like me ka hoʻēmi ʻana i ka hoʻokuʻu o nā papa paʻakai. Hana lākou i ka mahele o nā tubule mamao i kahi e hoʻololi ai ka paʻakai a me nā paʻakai pākia.I ka ikaika a me ka lōʻihi o ka hopena, he nui lākou i loko o ka "loop", akā ʻaʻole ka kumu i ka hypokalemia. ʻO nā poʻomanaʻo nui o kēia pūʻulu o nā lāʻau - spironolactone, triamteren - ʻokoʻa i ka ʻenehana o ka hana. ʻO Spironolactone kahi hana antagonist o ka ald testosterone, a ʻoi aku ka nui o kāna hana therapeutic, ʻoi aku ke kiʻekiʻe o ka pae a me ka hana i loko o ke kino o aldosterone. ʻO ka Triamteren ʻaʻole kahi antagonist o ka ald testosterone, ma lalo o ke ʻano o kēia lāʻau lapaʻau, ka māpuna o nā membranes o nā puna epithelial o nā tubula distally e koho pono no ka sodium ions, e waiho ana nā mea hope loa i ka lumen o ka tubule a waiho i ka wai, i alakaʻi ai i ka hoʻonui ʻia ʻana o ka urine.

ʻO ka hoʻomākaukau ʻana o ka pūʻulu osmodiuretic ka mea ʻaʻole i kahakaha ʻia ʻo ka urination. Hoʻopili ʻia, hoʻonui lākou i ka hoʻōho osmotic o ka "urine prim" (glomerular filtrate), kahi e pale ai i ka reabsorption o ka wai ma nā polocx proximal. ʻO ka diuretics osmotic ikaika (mannitol, a me nā mea ʻē aʻe) e hoʻohana i mea e hoʻoiho ai i ka diuresis ikaika i ka make ʻana i nā huaʻala (barbiturates, salicylates, etc.), ka mea pono ʻole o ka pale renal, a i ka hopena pūlohi o ka puʻuwai ma nā mea maʻi me ka hoʻokaʻawale i nā kānana renal. A me nā mea hoʻomakeke wai, ua hoʻohāʻule ʻia lākou no ka edema cerebral.

ʻO ka hoʻohana ʻana o ka carbonic anhydrase inhibitors (ʻike i nā Enzymes a me antifermenta) ma o ka diuretics ma muli o ka pale ʻana o ka hana a kēia enzyme i loko o nā pūpū (ʻo ka mea nui i ka tubula renal proximal). A ʻo kahi hopena, ua hoʻoneʻe ʻia ka hoʻokumu ʻana a me ka wehe o nā ʻano o ka hoʻoneʻe o ka carbonic acid, ke hoʻihoʻi nei ka reabsorption o nā bicarbonate ions a me nā huaʻai Na + e ka lula o ka epithelium tubular, a laila hoʻi i ka nui o ka hoʻōla wai me ka nui (hoʻonui ʻia diuresis). Ma ka manawa like, ua kū ka pH i ka urine a me ka uku, i ka pane ʻana i ka lohi o nā ion H +, e hoʻonui ana i ka ʻikepili metabola o nā kīʻaha K +. Eia kekahi, ua hoʻemi ʻia ka excretion o ka ammonium a me ke klorine, e hoʻomohala ana ka acidosis hypchloremic, i kahi e pau ai ka lāʻau lapaʻau.

Osmotic

ʻO ka loiloi o ka hana o ka diuretics osmotic ka hoʻonui ʻana i ka hoʻōho o ka osmotic i loko o ke kaila koko, e hoʻomaikaʻi ʻia, i kēia manawa, mai nā nui o nā kolo, ua kīwī ke kīwī ʻana a me ka nui o ke koko e pīhoihoi ai.

Hoʻemi kēia i ka reabsorption o ka sodium a me ka chlorine. Ke koho nei i kēia mau diuretics, pono e makaʻala i nā maʻi ʻaoʻao o ke kanaka, no ka mea hiki iā lākou ke loaʻa ka hopena maikaʻi loa i nā maʻi o nā puʻupaʻa a me nā puʻupaʻa.

ʻAʻole pāpā iki nā kauka i nā poʻe maʻi e koho diuretics ma luna o lākou iho: nā pūʻulu o nā diuretics i hōʻike i nā hiʻohiʻona, nā contraindications a me nā hopena ʻaoʻao. ʻO ka hoʻohana ʻana i nā mea kaha ikaika e hoʻonāukiuki ai i ka paʻū o ka paʻū a hōʻiliʻili paha i kahi mea, palapala hoʻolilo, hōʻeha hōʻeha, pilikia hypertensive. Me ka overdose o ka mana diuretics potent, hiki i ka lāʻau lapaʻau iho ke hoʻopau i ka hana ʻole.

Nā lauala

• nā mālamalama palpable,
• "ʻOmi" hāloe i nā ʻōpū, ka puʻuwai, nā kīʻaha koko.
• kāpae i ke kahe nui, holoi i ka ʻeha a me nā ʻōpū,
• hōʻike i kahi hopena laxative hopena,
• hoʻokaʻawale i ke kino me nā mea pono: mineral paʻakai, vitamina, mau mea kanu e ola ai,
• kūpono no ka hoʻohana ʻana i nā haʻawina lōʻihi (mau papa).

Nā hōʻailona no ka hoʻohana ʻana o ka diuretics loop: ka hana o ka hana a me nā contraindications

ʻO ka hōʻailona maʻamau no ke koho ʻana o ka diuretics ka maʻi hypertension arterial, ʻo ka hapanui o kēia mau mea pili i nā maʻi maʻi. Ua kuhikuhi ʻia nā lāʻau diuretic no ka mālama ʻana o ka sodium.

Me ka osteoporosis, ua kuhikuhi ʻia ka mea maʻi i ka diuretics thiazide. Hōʻike ʻia nā lāʻau lapaʻau kōpane o ka maʻi laena Liddle syndrome (kahi e pau ai ka nui o ka pāhana a me ka mālama o ka sodium).

Hoʻopilikia ka diuretics loop i ka hana o ka renal, i kuhikuhi ʻia no ke kaomi intraocular kiʻekiʻe, glaucoma, edema cardiac, cirrhosis.

No ka mālamaʻana a me ka pale ʻana i ka hypertension arterial, kuhikuhi nā kauka i nā lāʻau thiazide, kahi i nā wai liʻiliʻi he hopena akahai ka poʻe maʻi me ka maʻi hypertension. Ua hōʻoia ia aia ka diuretics thiazide ma prophylactic doses hiki ke hoʻemi i ka hopena o ka maʻa.

Ke lawe ʻole ʻia nei i kēia mau lāʻau i ke koena kiʻekiʻe, he puʻu ʻia me ka hoʻomohala ʻana o ka hypokalemia.

I ka mālamaʻana i ka diuretics, hōʻikeʻokoʻa ka hana a me ke kākoʻo kākoʻo. Ma ka hana ikaika, ua hōʻike ʻia nā hemahema haʻahaʻa o ka diuretics (Furosemide). Me ka mālama mālama maʻi maʻamau, hoʻohana maʻamau i ka diuretics.

ʻO ka poʻe maʻi me ka cirrhosis decompensated o ka palani, hypokalemia, hoʻohana ʻia i ka diuretics. ʻAʻole i kuhikuhi ʻia ka diuretics Loop no nā poʻe maʻi e hōʻole nei i kekahi derivatives sulfanilamide (hypoglycemic a me nā lāʻau maʻi antibacterial).

No ka poʻe me ka ʻōpū o ka hanu ʻana a me ke aʻa ʻole o ka renal, ua hui ʻia ka diuretics Ua hoʻohālikelike ʻia nā diuretics o ka hui thiazide (Methiclothiazide, Bendroflumethiozide, Cyclomethiazide, Hydrochlorothiazide) i ke ʻano type diabetes diabetes mellitus, me ka mea maʻi e hoʻonui koʻikoʻi i nā pae glucose koko.

Vientricular arrhythmias pū kekahi mau contraindications pili i ka wae ʻana o ka diuretics.

No nā mea maʻi e lawe ana i ka paʻakai lithium a me nā glycosides cardiac, ua kuhikuhi ʻia ʻo ka diuretics loop me ka mālama nui.

I ka mālamaʻana i ka diuretics, hōʻikeʻokoʻa ka hana a me ke kākoʻo kākoʻo. Ma ka hana ikaika, ua hōʻike ʻia nā hemahema haʻahaʻa o ka diuretics (Furosemide). Me ka mālama mālama maʻi maʻamau, hoʻohana maʻamau i ka diuretics.

Hoʻopilikia maoli nā lāʻau Diuretic i ka hana a ka wikiwiki a wikiwiki i ke kaʻina o ka urine excretion.

Ka hana o ka hana o ka hapanui o nā diuretics, ʻoiai inā he paʻakai potassium-sparing, ua kau ʻia i ka hiki ke kīpē ʻana i ke kūoʻi ʻana i loko o nā pūhaka, ʻoi aku ka nui o ka pūne renal, electrolytes.

ʻO ka hoʻonui ʻana i ka nui o nā electrolytes i hoʻokuʻu i ka manawa like me ka hoʻokuʻu ʻana i kekahi nui o ka wai wai.

ʻO ka diuretic mua i kū mai i ka kenekulia 19, i ka manawa i loaʻa ai kahi lāʻau lapa kala, kahi i hoʻohana nui ʻia e mālama i ka syphilis. Akā e pili ana i kēia maʻi, ʻaʻole pono ka lāʻau, akā ua ʻike ʻia kona hopena diuretic ikaika.

Ma hope o kekahi manawa, ua hoʻololi pono ke hoʻomākaukau i ka mercury me kahi mea e ʻemi ʻole ʻia.

ʻAʻole liʻuliʻu, hoʻololi i ke ʻano o ka diuretics i alakaʻi i ka hoʻokumu ʻana i nā lāʻau diuretic ikaika loa, aia kā lākou papa inoa ponoʻī.

Ua kuhikuhi ʻia nā diuretics no nā kūlana a me nā maʻi i mālama ʻia e ka mālama wai ʻana.

• ʻālaʻi nephrotic
• osteoporosis
• ka hoʻopiʻi ʻana i ka ʻōpū o nā ʻoihana haʻahaʻa me ka paʻa ʻole o ka naʻau,
• ke koko kiʻekiʻe (arterial hypertension),
• hiʻona pinepine o ka ald testosterone,
• glaucoma
• nā helehelena o ka pūpū a me nā ate,
• hanalawa puʻuwai aloha ʻole,
• ka ʻaʻa ʻana o nā ʻili.

E aʻo e pili ana i ke kumu o ke kanesa ʻo ka wahine ma ka wahine a me nā kānāwai o ka mālama ʻana i nā hoʻonaʻauao.

Hōʻike ʻia nā ʻōkuhi no ka hoʻohana ʻana i ka hōʻiliʻili urological ʻo Fitonephrol ma kēia ʻaoʻao.

Ke koho nei i nā lāʻau diuretic, e noʻonoʻo nā kauka i nā palena. Aia kēlā me kēia lāʻau lapaʻau kahi papa inoa o nā contraindications (i hōʻike ʻia i nā ʻōlelo kuhikuhi). ʻAʻole kuhikuhi ʻia nā diuretics synthetic āpau i ka wā o ka hapai:

• nā makahiki o nā keiki
• lactation
• hapai
• hypersensitivity i phytoextract a i ʻole māhele o ka diuretics synthetic,
• maʻi mellitus maʻiʻi
• ʻano paʻakikī o kahi pilikia ʻole.

Ma mua o ka noʻonoʻo ʻana i ka ka hana o nā lāʻau like thiazide-like, pono e hoʻomaopopo i ka mea o ka diuretics thiazide.

Ma kahi kīʻahi, ʻo kēia keʻano o ka diuretics synthetic me kahi hopena hypotensive lōʻihi.

Kānāwailua ʻo ka diuret Thiazide ma muli o ko lākou hiki i ka mālama ʻana i ka maʻi hypertension a me ka nele o ka naʻau. Loaʻa ka maikaʻi o thiazide a me ka thaizide-like diuretics i hoʻohālikelike ʻia me nā diuretics ʻē aʻe i nā mea paʻa ma ka hoʻohana ʻana i ka paʻakai me ka meaʻai.

Eia kekahi, ʻo ka diuret thiazide (like-likeia ʻo thiazide) e mālama ana i ka calcium, no laila e hoʻohana kēia mau lāʻau i ka helu No 1 i ka mālama ʻana o ka hypertension a me ka hoʻokō ʻana i ka puʻuwai ma nā mea maʻi me nā osteoporosis.

Hoʻohana ka Thiazide-diuretics no ke kuapo ʻana, ke koko, ka maʻi ʻōpū.

• Ka mea huehue, i hana ʻia ma muli o ka maʻi ʻōlima, kahi hōʻailona i ka hōʻino ʻia o ka palaki o ka wai-paʻakai. Eia nō naʻe, he haʻahaʻa ka ulu ʻana o ka diuret thiazide no ka mālama ʻana i kēia maʻi.
• ʻO Edema ma o ka cirrhosis. Hoʻohana pinepine e launa me nā diuretics ʻē aʻe.
• Ke koko kiʻekiʻe.
• Ka huehue a paʻakikī ka hopena.

I ka maʻamau maʻamau, hoʻohana ʻia nā lāʻau o kēia pūʻulu e mālama i ka maʻi o nā urinary a me nā pūnaehana urinary. Ke hana nei kēia mau lāʻau me ka ikaika maʻalahi, ke hōʻike nei ka hopena iā ia iho ma hope o hoʻokahi manawa a ʻekolu mau hola, a lōʻihi ka lōʻihi ma kahi o ka hapalua lā.

ʻO ka hana o ka hana ka pale i ka hoʻohālikelike o ka sodium a me ka wai i loko o ka tubula renal proximal, ma kahi o ka hana i ka wā i hoʻopuka ʻia ai i loko o ka urine i kahi wikiwiki wikiwiki. Eia kekahi, hoʻoneʻe ka thiazide diuretics i ka excretion o ka calcium, me ka pākahi a me ka ikaika o ka hoʻokumu ʻana i ka waikū uric i loko o nā keiki.

Hōʻike ʻia kēia ʻano diuretics ma nā ʻano pili o kēia pilikia:

• ka leo edematous
• hypertension arertial, ʻaʻole i kāpae ʻia e nā ala maʻamau, e hōʻemi ana i nā ke kaha ikaika,
• ka huakai a me ka wīwī o ka puʻuwai hema.

ʻO nā lāʻau lapaʻau nui o kēia pūʻulu e noʻonoʻo i ka chlortiazide a me hydrochlorothiazide, ka hoʻomaka ʻana o ka hana kūpono a puka i loko o nā hola mua, a lilo ko lākou hopena i nā hola.

ʻO nā hopena ʻaoʻao kekahi o nā hana hoʻohiwahiwa liʻiliʻi liʻiliʻi, ʻoiai nā hoʻololi o ke kaohi o nā mea pākuʻi a me nā huaora. Pēlā nō hoʻi, ka hypokalemia (ke emi ʻana o ka paʻū o ka pāhana i loko o ke koko) i kekahi manawa i loaʻa mai ka hopena ʻaoʻao, i ka wā e hoʻolaʻa iki ʻia ka lāʻau a me nā mea kanu me nā manaʻo kiʻekiʻe o kēia ʻatikala (panangin, asparkum) i kau ʻia.

Hiki iā ʻoe ke hoʻomaopopo i kahi emi pinepine o ka nui o ka sodium i ka plasma, a me ka hoʻonui ʻana i ka hoʻoweliweli ʻana o ka waikū uric. ʻO ka hope, ke huli nei i ka lāʻau o ka hoʻopili ʻana, a pili pū kekahi i nā parenchyma o ka lolo. Ma hope o ka pau ʻana o ka hoʻohana ʻana i kēia lāʻau lapaʻau, hoʻoikaika kino ʻokoʻa i ke kino holoʻokoʻa.

Inā lawe nā mea maʻi me ka diuretics i nā beta-blockers, a laila hiki ke hopena i kahi hopena'ē aʻe o ka glucose metabolism.

ʻO nā ʻano contraindications, penei:

• nā maʻi hui pūʻili
• ʻO nā maʻi kānana glomerular i loko o nā pūpū,
• i ka emi ʻana o ke kō o ka paʻakai a me ke kō ma ka lolo koko,
• hapai a me ka wā o ka umauma,
• maʻi kūlohelohe a i ʻole mololia i kekahi o nā mea o ka lāʻau.

I kēia mau lā, loaʻa i kahi lāʻau lapaʻau ka loaʻa mau o kēia mau lāʻau lapaʻau, hiki iā ʻoe ke kūʻai no ke kālā liʻiliʻi ʻole me ke kauka ʻana o kahi kauka. Eia nō naʻe, he mea nui loa ke kuhikuhi ʻia ke koho ʻana i kēia mau lāʻau lapaʻau e kekahi kauka kūpono, e hōʻike ana i ka nui o ka hopena, ka lōʻihi a me ka lōʻihi o ka ʻoihana. E hiki mai ana, e haʻi pōkole mākou iā ʻoe e pili ana i nā lāʻau lapaʻau nui mai kēia hui.

ʻO ka hoʻomākaukau ʻana o kēia subkākia he hopena diuretic ma muli o ka pale ʻana i ka hoʻihoʻi ʻana o ka huika o ka sodium i ka pōʻai o Henle, ʻo ia hoʻi i kona kuli pihi.I kēia hihia, kahi e hoʻonui ai i ka excretion o ka calcium, bicarbonates, magnesium a me nā phosphates i loaʻa.

Loaʻa ka loop diuretics i ka hopena veno-hoʻonui e like me ka loli i ka hana ʻana o nā prostaglandins e nā keiki. ʻO kēia hana e hōʻemi ai i ka neʻe ma ka ventricle hema o ka puʻuwai a kōkua i ka hōʻemi o ka edema pulmonary.

I waena o kēia mau lāʻau āpau, ʻo ka furosemide loop diuretic ka hoʻohana nui ʻia.

Hana nā diuretics i ke ʻano o ka mea hana o ka lālau e wehe ai i nā kī sodium a me ka wai ma o nā keiki. Hoʻohana pinepine ia e like me ke kōkua wikiwiki, no ka mea, ʻo ka hana maʻamau e tupu i ʻole ma mua o 6 mau hola.

ʻO ka hoʻohana lōʻihi a ʻaʻole i kāohi ʻole i ka diuretics loop e hiki ke hōʻeha i ka naʻau ma muli o ka nalowale o ka konupora a me ka pāhare. Hiki ke hoʻohana inā he kīnā ʻole i ka hana.

I waena o nā contraindications, hiki ke hoʻomaopopo ʻia nā kūlana i lalo nei:

• myocardial infarction
• huehae huehal i pau
• uhaiki pohihihi
• lōkohu
• nā ʻāpana pōhaku
• kohola
• stigosis urethral,
• haaheo
• stenosis aortic,
• nā haunaele i ka paona wai-electrolyte,
• hoʻohaʻahaʻa koko haʻahaʻa (loop diuretic hiki ke hoʻohaʻahaʻa i ka hoʻokahe koko koko).

Papa o nā waihona:

• e hoʻopau i ka puff,
• hōʻoluʻolu o ka cardiovascular gagal,
• huʻi no ka urine ma muli o ka maʻi ʻeha a me nā hana maʻi diuretic,
• hana no ke koko koko kiʻekiʻe
• ka hemo ʻana o nā mea i pau a me nā mea inu make.

Nā hopena ʻaoʻao a me nā contraindications.

Papa o nā waihona:

• ʻO ka edema o ka renal a me ka cardiac puka mai e wehe i nā wai nui.
• Ka nele o ka Hepatic e hōʻemi i ka hoʻohālikelike a me nā loli i ka pae wai-paʻakai.
• ʻO Urolithiasis e wehe i ka calcium nui a pale i nā pōhaku keiki.
• Hoʻololi i ka lolo (diabetes insipidus) maʻi e hoʻololi i nā loli pathological e pili ana i ka neʻe ka wai.
• ʻO ka hypertension ma ke ʻano o ka lāʻau paʻakikī i nā lāʻau antihypertensive e hoʻoikaika a hoʻolōʻihi i ka hopena.
• Pono e hoʻonui i nā hopena o nā lāʻau lapaʻau.

Ma muli o ka hoʻonui ʻia o ka diuresis a me nā loli o ka koena o ka wai-paʻakai, ʻoi ʻia ka hoʻomākaukau ʻana no ka thiazide no ka make a me ka hoʻohuihui me nā paʻakai paʻakai.

• ʻO nā maʻi o nā hui me ka hoʻopili ʻana i nā hana o ka uric acid.
• ʻO nā hoʻololi i loko o ka hana wai-paʻakai, a me ka hoʻonui ʻia ʻana o ka waikika uric.
• ʻO ka wā kahiko, ka wahine a me ka lactation. ʻAʻole kūpono ʻia nā ʻano me nā diuretics o kēia ʻano no kahi keiki.
• ʻO ka hemahema o ka pēpē a me ka ate i ka hana ʻoi
• ʻO ka maʻi Asthenic.
• ʻO ka maʻi antihypertensive.
• ʻO nā maʻi o ka kuʻi adrenal me ka hana hormonalaka ʻole.

ʻO nā hoʻohālikelike i ka lawe ʻana i ka diuret thiazide ʻo ia ka mea pono e hoʻokō ʻoe i kahi hopena diuretic ma nā ala ʻē aʻe, e hoʻohana pinepine ʻia nā mea kime a me nā mea osmotic.

Hōʻalo i nā mea momona e hoʻonui i ko lākou filtration hiki i kahi loop diuretics.

Ke hoʻohālikelike nei kēia mau lāʻau i ka hoʻomaha ʻana o ka uaua maʻa vascular, hoʻonui i ka kahe koko, e hoʻoikaika i ka hana o ka prostaglandins E2 a me I2 i nā vascular cell, a hoʻonui i ka filomation glomerular.

Ma muli o kēia mau kaʻina hana, ʻike ʻia ka nui o ka hopena diuretic.

Hoʻomaopopo ʻia nā lāʻau lapaʻau no ka hoʻomohala ʻana i nā ʻano o nā pathological a me nā kaʻina e like me:

1. ʻO ka maʻi Cardiac, hepatic a renal edema. Hoʻomaopopo koke ʻia lākou ma hope o ka hana ʻana o kēia mau ala.
2. Hoʻopau ʻole nā ​​hopena hanaliki. Hāʻawi ʻia nā wahi me ka hiki ke hoʻomaikaʻi i ke kahe koko renal a me ka wikiwiki i ka hoʻopiʻi ʻana o ka urine ma anuria.
3. ʻO ka Hypercalcemia. Hoʻopili i ke kūmole i ka calcium mai ke ana kino.
4. ʻO ka maʻi maʻi, akā ʻo ka mea ke hoʻopulapula paha ka mea maʻi.I nā hihia āpau a pau, i manaʻo ʻia ke koho ʻia o ka diuretics thiazide.

Hoʻohana ʻia nā mea kumu no ka mālama ʻana i ka diuresis ikaika i mea e make ai ka mea, me ka hāʻawi ʻana i nā kōkua huakaʻi no ka hoʻokūkū i ka edema pulmonary a i ʻole ka lolo.

• kaohi ʻana i ke kahe o ka urine i loko o ka ʻāpana,
• ʻeha nā puʻuwai naʻau,
• maʻi o nā lāʻau lapaʻau e pili ana i ka hui sulfonamide,
• hapai a lactation.

Hoʻohana nui i nā ʻāpana

Loaʻa nā uku mai nā mea kanu no ka hypertension a me ke ʻano type type 2 a hoʻomaikaʻi maikaʻi i ke ʻano maʻamau o kahi kanaka.

ʻO nā lāʻau maʻi hypotensive kūpono maikaʻi loa no ka maʻi diabetes i ka diuretics. Mahalo iā lākou, ua hana ʻia kahi hana pilikino e hoʻonui ai i ka nui o ka urine i loko o ke kino, kahi e piʻi ai i ka piʻi o ke kiʻekiʻe o nā hana excretory, me ka hoʻokuʻu koke ʻana i ke kino o ke kanaka mai ka wai a me ka nui o ka paʻakai.

ʻO ka hopena, ua hoʻouka ʻia ka ʻōnaehana holoʻokoʻa, ke hoʻoneʻe nei ke koko a me nā kīʻaha koko like ʻole.

Nā maʻi hū

ʻO ka hana ʻino ʻana o nā protein ka ka pili me ka nele o ka pāhare, e alakaʻi ana i ka pale o ke koena o ka nitrogen. Hoʻokumu pinepine ia i nā keiki a me ka poʻeʻelemakule me kahi haʻahaʻa haʻahaʻa haʻahaʻa o ka meaʻai. No ka hoʻoponopono ʻana i kēia ʻano, pono ia e hoʻomaikaʻi i ka ʻai me nā protein a kuhikuhi i nā steroid anabolic.

Ke hoʻohana nei i ka thiazide a me ka diuretics loop i loko o ke koko, ke kaohi ʻana o ka cholesterol, beta-lipoproteins, hoʻonui i ka triglycerides. No laila, i ke koho ʻana i nā diuretics, pono e kaupalena ʻia ka lipids i ka meaʻai, a inā pono, pono e hui pū ʻia ka diuretics me ka haniotensin-hoʻohuli i ka hoʻohiolima o ka huakaʻi (ACE inhibitors).

Hiki i ka maʻi diuretic Thiazide ke kumu i ka hoʻonuiʻana i ka hoʻoliʻi glucose o ke koko (hyperglycemia), ka mea nui i nā mea maʻi me ka maʻi mellitus a i ʻole nā ​​mea hoʻonā. I mea e pale ai i kēia kūlana, hāʻawi ʻia kahi palena i ka ʻai ʻana me nā kalapona.

I ka poʻe me ka hypertension a me ka metaboline purine metabolism, he nui o ka piʻi ʻana o ka waikika uric i loko o ke koko pea (hyperuricemia). ʻOi aku ka nui o ka hopena o kēlā me ka hoʻopiʻi i ka mālamaʻana i ka diuretics thiazide. No ka mālamaʻana, he mea laʻai paʻa ʻole i kapu ʻia, allopurinol, e kau ʻia, ua hui pū ʻia nā diuretics me nā mea paʻa o ACE.

Ma ka hihia o ka hoʻohana lōʻihi ʻana i nā inikua nui o nā lāʻau diuretic, hiki ke kīpī ka hana ʻana me ka hoʻomohala ʻana i ka azotemia (he nui ka piʻi ʻana o nā mea wela o ka haehae i loko o ke koko). I kēia mau hihia, pono e nānā pinepine i nā hōʻailona azotemia.

Ke luhi ka diuretic. ʻO ia ka hiʻohiʻona maʻamau o ka thiazide a me diuretics loop, ʻo ka mea nui i nā mea maʻi me ka aleritisamides e pili ana. Hiki i kekahi hopena alia ke ʻano me ka ʻeha o ka ʻili, vasculitis, photosensitivity, maʻi, nā ʻeha a me nā hana o ka ʻōpū.

ʻO ka hopena no ka maʻi maʻi e hana e like me ka papa hana maʻamau me ka hoʻohana ʻana o antihistamines a me prednisone.

ʻO ka hoʻohana ʻana i ka carbonic anhydrase inhibitors hiki ke hele pū me ka hana ʻole o ka pūnaehana. ʻO ke poʻo, ka ʻōpū, ka paresthesia, ke hele mau nei ka lūlū.

Me ka hoʻokūkū intravenous acid o ka waʻa ethacrine, hiki ke hōʻino ka make i ka ʻōnaehana hoʻolohe.

Hiki i nā hui āpau o nā lāʻau diuretic ke hoʻonui i ka nui o ka hoʻomohala ʻana i ka urolithiasis.

• hypovolemia,
• hypokalemia (e hoʻonui nui i ka maʻi o ka glycosides cardiac),
• hyponatremia,
• hyperuricemia (hiki ke hoʻonāukiuki i kahi huʻi o ke gout),
• hipolopa,
• pālahalaha maʻi
• ʻO ka hypomagnesemia - ke lilo ʻana o ka magnesium i manaʻo ʻia he kumu kūpono o ka pseudogout (chondrocalcinosis),
• āhāhuʻe
• mai nāwaliwali
• hypotension.

No ke aha e hoʻohana ai i nā diuretics no ka maʻi maʻi

ʻO ka pinepine, ʻo nā ʻano lāʻau diuretic i kuhikuhi ʻia i ka hoʻāʻo ʻana e hoʻōla iā hypertension. Akā ʻōlelo ke kaukaʻi nei nā kauka i kēia mau ʻōhua no ka cirrhosis a me ka wāwae o ka wāwae. A ʻaʻole kēia he ulia, no ka mea hiki i kēia mau maʻi ke hōʻike i ka loaʻa ʻana o ka puʻuwai naʻau.

Ma ka maʻi mellitus, pono e hoʻohana ʻia nā diuretics i ka nīnau me ka makaʻala nui loa, no ka mea, ʻaʻole kūpono nā diuretics āpau no kēia a ʻo ia ʻano meaola. No laila, he mea pono e hele i kahi kūkākūkā mā mua me kahi loea lapaʻau e hiki ke hōʻike i nā lāʻau lapaʻau e hiki ai ke inu i ka maʻi ʻokoʻa.

E like me ʻoe e ʻike ai, hiki i nā lāʻau lapaʻau diuretic nā ʻano like ʻole o nā ʻano ʻano like ʻole. No ka hoʻohālikelike, ʻaʻole kūpono nā hui o ka potassium-sparing a me nā loopback o ka lāʻau i mea e hoʻopō pono ai i ka hypertension i ka maʻi mellitus.

He mea nui ia e hoʻomaopopo he kūpono kūpono kēia papa helu no ka hoʻohana hoʻokahi, ʻo ia hoʻi, i ka wikiwiki e hoʻopau koke i ka hōʻeha hōʻeha i kū mai. ʻO ka liʻiliʻi liʻiliʻi i ka manawa i nīnau ʻia he mau diuretics potassium-sparing, no ka manawa o kēia manawa ua manaʻo ʻia ʻo lākou ka mea maʻamau a paʻa i nā hopena maikaʻi ʻole ʻē aʻe.

ʻO Thiazide e like me nā kuikini thiazide

E like me nā ʻaina ʻo Thiazide like me thiazide i ʻike ʻia ka mea kaulana loa i ka mālama ʻia ʻana o ka maʻi mellitus, a me ke ʻano maʻi hypertension. Ua noʻonoʻo ʻia i ka diuretic diuretics no ka maʻi o ka lua o ke ʻano he hiki i ka nui o ka hana.

ʻO kēia ka Poithiazide a me Dichlothiazide. ʻO ko lākou palupalu ma muli o ka hiki ke hoʻohaʻahaʻa i ka pae o ka mālama ʻana i nā ʻōnaehana i ka insulin hākana i hāʻawi ʻia.

ʻO ka pinepine, ʻo kēia hanana e hana ma muli o ka hoʻohana maʻamau a me ka nui o nā lāʻau lapaʻau. ʻO kaʻoiaʻiʻo, hiki i kēlā mau hihia ke kū i mua ma ke ʻano o nā ʻano like ʻole.

Hiki i nā lāʻau 'diuretic like-Thiazide ke lawe ʻia e nā mea maʻi me ka maʻi maʻamau me ka makaʻu ʻole. ʻO nā aila e like me ka indapamide nā mea ʻoluʻolu loa.

Ke hoʻohana nei i kēia mau mea, hiki ke hoʻokaʻawale i ka potassium, sodium, magnesium mai ke kino. No laila, me ka hoʻōla koʻikoʻi, pono me ka mea maʻi me ka maʻi maʻi ʻaʻai e ʻai i nā meaʻai i loaʻa i nā mea paahi o luna.

ʻO kēia a me ka pīhoihoi o ka buckwheat, oatmeal, Berries, nā huaʻai a me ka pono o nā hua hou.

Me ka maʻi diabetes, hiki nō hoʻi ke paʻi ʻia ka lāhui. Eia nō naʻe, ma mua o ka hoʻohana pololei ʻana, pono e kūkā me ke kauka e hoʻokumu i ka nui o ka pauka a nānā i nā mea no ka hoʻohui pū me nā mea lapaʻau kumu.

Pono ke nānā ʻia kekahi mea maʻi me ka maʻi maʻi inā ua kuhikuhi ʻia ka mālama ʻana i nā maʻi hakakā, no ka mea, ʻo ka pono o ka insulin i loko o kēia hihia ke ʻano nui ma lalo o ke ʻano o nā lāʻau lapaʻau e pili ana i ka metabolism o nā pakano (corticosteroids, salicylates).

Hoʻopilikia i nā mea hoʻokele Beta-adrenergic ka hoʻokuʻu ʻana o ka glucose mai ka palū i ka wā o ka hoʻomohala ʻana i ka hypoglycemia, ka mea i hoʻomohala ʻia e ka poʻe beta2-adrenergic receptors, a me ka hoʻohaʻahaʻa i nā hōʻailona o ka hypoglycemia, me ka ʻae ʻole o ka sweating. No laila, hoʻonāukiuki ʻia ka hypoglycemia e ka insulin a lilo i ʻōlelo ʻole ʻia ma ke ʻano.

I kēia mea, inā pono ke kuhikuhi ʻia ka mea maʻi me ka maʻi maʻi maʻi beta-adrenergic receptor, cardioselective beta-1-blockers, no ka laʻana, ka atenolol, pono e hoʻohana. ʻO ka lāʻau sympatolytic hoʻi ke hoʻomoʻa i ka hopena o ka insulin.

Hiki i nā Thiazide diuretics ke hoʻonāukiuki i ka hoʻomohala ʻana o ka maʻi diabetes, no laila, kūlohelohe, ka hoʻoponopono ʻana o ka hypertension i ka mellitus maʻi diabetes koi pono ka mālama kūikawā.Hoʻoulu ʻia ka hana o ka derony o ka sulfonylurea e nā dosis nui o sulfanilamides, a ʻo kekahi o lākou e hoʻonui aʻe i ke kiʻekiʻe o ka butamide free, ʻoiai paha ma muli o ka hoʻokūkū no ka launa pū me ka protein plasma.

Monoamine oxidase inhibitors potentiate nā hopena o nā lāʻau hypoglycemic, a hiki paha i ka insulin. Hiki iā lākou ke hōʻemi i ka momona, no laila ke hoʻololi nei i ka pono o ka insulin. Hiki iā ia ke launa pū me ka ethanol me ka ulu ʻana o ka hypoglycemia, me nā anticoagulants ma ke ʻano o ka hoʻokūkū no nā enzyme o ka naʻau, etc.

Hiki i nā mea hoʻohālikelike o nā huakaʻi hepatic microsomal e hoʻoulu i ka metabolism o nā derivatives o ka sulfonylurea i hoʻoneʻe i ka ate, no ka laʻana, akā ʻo ka butamide. ʻO kā lākou neʻe mai ka kamaʻilio ʻana me ka protein plasma e hana pū me ka mālama like me ka clofibrate, kekahi mau lāʻau anti-inflammatory anti-inflammatory a me sulfonamides.

ʻO nā dosis nui o ka acetylsalicylic acid he hopena hypoglycemic. Hōʻike kēlā mau hoʻohālike āpau i ka hiki o ka hōʻiliʻili o nā lāʻau lapaʻau i ka mālama ʻana i nā mea maʻi me ka maʻi diabetes he mea kū maoli nō ia.

ʻO nā Pharmacokinetics o nā lāʻau lapaʻau no ka maʻi maʻi

ʻO nā maʻi pēpē e hoʻopiha nei i ka maʻi diabetes me ke hoʻololi ʻana i ka excretion o nā lāʻau he nui. ʻO ka pīhoihoi Penicillin i ka wā o ka hoʻokele intramuscular he nui ka lohi i ka poʻe maʻi maʻi me ka maʻi mellitus ma mua o nā mea i loko o ka hui mālama.

Ke alakaʻi kēia i ka emi o ka hōʻemi nui loa o ka lāʻau i ke koko. ʻO ka emi ʻana i loko o ka laweʻana, aia paha ia ma muli o ka microangiopathy maʻi maʻi. Hoʻololi ʻia nā loli like ʻole o ke kōpili o nā lāʻau ʻē aʻe a ʻaʻole hiki ke loaʻa i kahi hopena koʻikoʻi.

ʻO ka maʻi lapaʻau-hoʻonāukiuki

Ma hope o ka hoʻopuka ʻana o ka diuretika thiazide i loko o ka hana lapaʻau i ʻike ʻia ai, me ka hoʻohana mau ʻana, hoʻonui lākou i ka hyperglycemia i nā maʻi me ka maʻi mellitus, a ma hope ua hoʻohuli ʻia ka hoʻohaʻahaʻa glucose i kekahi mau kānaka olakino. Me ka hoʻomanawanui lōʻihi, hoʻonui lākou i ka nui o nā mea maʻi me ka hoʻomanawanui i ka hoʻohaʻahaʻa glucose.

ʻAʻole paʻa ke kumu o kēia hana. Hōʻike lākou i ka hiki o ka pilina me ka nele o ka pāhare. Ma ka hoʻopau ʻana o ka hoʻōla, hoʻi ka pae i hoʻohaʻahaʻa i ka mua, me ka ʻokoʻa o nā mea maʻi i loaʻa i ka prediabetes ma mua o ka mālama ʻana.

Pono e noʻonoʻo ʻia ka hopena o ka hoʻomohala ʻana i ka maʻi maʻi i ka wā e mālama ai i nā poʻe maʻi me ka maʻi hypertension maʻalahi, ʻoiai ka hoʻomohala ʻana i ka maʻi maʻi maʻi lua ʻole me ke ʻano hemo ʻana i ka waiwai o ka hopena hypotensive o ka diuret th thiazide.

Diuretics pākakai-sparing

E hoʻomau i ka wailua o ke koko (BP), kahi diuretics no ka maʻi diabetes. Ua kau ʻia lākou i ka wā e loaʻa ai ka ukana nui ma ka ʻōnaehana cardiovascular (CVS) a i ʻole he ʻaeʻe ʻana i ka hana o nā urine excretion e nā keiki.

Kahi ʻia ka papa lāʻau koʻikoʻi ma luna o ka mīkini o ka hana, kahi e koho ʻia ai ke koho ʻana i nā lāʻau lapaʻau ma kekahi kiʻi haukaʻi o kekahi maʻi.

I ka hihia o ka maʻi diabetes mellitus (DM), ua hoʻohālikelike ʻia nā lāʻau lapaʻau ʻē aʻe, no laila kanu ʻia nā diuretics e nā kauka hele wale nō e like me nā lāʻau lapaʻau ma ka papa inoa. He nui nā hopena ʻaoʻao o lākou.

Ke koho nei i kahi lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko i ka maʻi diabetes i ka kiʻi kime o ka maʻi, ke kūlana olakino o ka maʻi, ka makahiki a me ke kumu o ka hoʻohana. Hoʻoholo ke kauka i ke kumu o ka hōʻiliʻili o ka wai a, ma ka kumu o kēia, ua kuhikuhi ʻia kahi diuretic.

Me ka maʻi maʻamau 1 ʻano, hoʻohālikelike ʻia i ka hui thiazide o nā lāʻau lapaʻau i nā pupu liʻiliʻi. Hoʻopilikia kekahi o nā lāʻau lapaʻau i ka hoʻoliʻi glucose, pono e noʻonoʻo i ka wā e inu ai. Hoʻohana ʻia ka wikiwiki o ke kahe koko e hoʻohana ana me ka diuretics loop.

Nā ʻano huaʻai Diuretics

Pono kēlā me kēlā me kēia maʻi i ka lāʻau lapaʻau e hana pololei ana i ke kumu o ka maʻi. Loaʻa i nā lāʻau diuretic kahi hana like ʻole. Wahi a kēia ʻano, ʻokoʻa kēlā me kēlā diuretic i kekahi hui.

• ʻO nā lāʻau lapaʻau e pili ana i ka hana ʻana o nā tubula renal i komo: "Chlortalidone", "Clopamide", "Cyclomethiazide",
• diuretics me ka hopena osmotic (no ka laʻana, "Monitol"),
• Diuretics pākoleka-paʻakai: Veroshpiron.

Hoʻokaʻawale ʻia nā diuretics a pau i nā pūʻulu e like me ka hopena o ka sodium excretion.

• me nā hana kūpono mai ka 15% a ʻoi aku,
• me ka awelika o ka 5-10%,
• hiki ʻole ke hoʻoneʻe i ka 5% a i ʻole ka liʻiliʻi mai ke kino.

Loaʻa i kēlā me kēia diuretic kona kumu kikoʻī. Hoʻopau ka diuretics me ka hana maikaʻi i ke kino i ka hui pū me nā lāʻau ʻē aʻe. I nā haʻawina, ua ʻike ʻia ʻo ke kiʻekiʻe o ka ʻai o ka protein i ka urine, ʻoi aku ka nui o ke kaomi me ka hypertension.

Nā hui Diuretic

Ua hoʻokaʻawale ʻia nā diuretics i nā hui e like me ka ka mana o ko lākou mana ma ke kino:

1. ʻO Loopback - e hoʻopau pono i ka wai nui i ka manawa pōkole. Hoʻokuʻu ʻia kēia: "Furosemide", "Ethacrylic acid" a me nā mea ʻē aʻe.
2. Hoʻopau pinepineʻia nā Thiazide diuretics - e noʻonoʻo ʻia ʻo ia kekahi o nā lāʻau lapaʻau maikaʻi loa. E hoʻemi wikiwiki i ka pīpī a kōkua i ka hoʻohemo ʻana i ka puhi. Hoʻouna kēia: "Hypothiazide", "Indapamide", "Dichlothiazide".
3. Nā diuretics Osmotic - wehe i ke kahe i ka manawa pōkole. Hoʻohana ʻia i nā hihia pōpilikia. Pāpā ʻia no ka hoʻohana lōʻihi. Loaʻa kēia me: Urea, Mannitol, Potiteta Acetate.
4. Hoʻokomo ka potoma-sparing diuretics i ka hoʻopōʻino ʻana i ka pale o ka electrolyte, e hāʻawi i ka excretion o ka pāhana a me ka sodium mai ke kino. Aia nā mea: Triamteren, Spironolactone.

Hoʻopilikiaʻia nā hopena ʻaoʻao e ka hoʻohanaʻana o ka diuretics i ka mālamaʻana i ka maʻi diabetes no ka manawa lōʻihi. No laila, i mea e hoʻohana pono ai i ka lāʻau lapaʻau me ka ʻoi loa o ka maikaʻi, pono ke kauka e kuhikuhi iā ia ma hope o nā hoʻokolohua pono a pau a me nā hoʻokolohua.

Kūkulu ʻia kēlā mau diuretic i ka mālama ʻana i ka maʻi mellitus no ka maʻi mellitus, ka mea nona ka thiazide a i ʻole ʻoia ʻo thiazoid. ʻO nā diuretics nona nā thiazide (Dichlothiazide, Poithiazide) a lawe ʻia no ke hypertension me ka type 1 diabetes mellitus e ʻoi loa ana i nāosa liʻiliʻi.

Hoʻohana pinepine, diuretics e hui pū me nā lāʻau lapaʻau ʻē aʻe.

Hoʻohana pinepine ʻia kahi diuretic e like me Hypothiazide i ka mālama ʻia o ka mālama kino ʻana i ka maʻi mellitus a me ke koko. ʻO kekahi o nā hiʻohiʻona maikaʻi loa ia mau ʻano o ka lāʻau lapaʻau, ka mea e hoʻopili i ka hoʻololi ʻana o ka glucose a me ka kolamu.

ʻAʻole kōkua ʻia nā diuretics no ke ʻano maʻi type 2 i ka nui. ʻO nā diuretics e pili ana i ka pūʻulu thiazide kahi waiwai e hoʻopili ai i ka hana o ka insulin a hoʻonui i nā pae glucose.

ʻAʻole ʻōlelo ʻia ka lāʻau diuretic no ka maʻi diabetes, no ka potassium-sparing a loop paha. ʻO kahi haole he mea hoʻokō hoʻokahi hana no ka hana koke ʻana i nā hanana pōpilikia.

ʻO ka diuretics ka pūnaewele antihypertensives koʻikoʻi nui loa. Hoʻonui maoli lākou i ka nui o ka urine i loko o ke kino o ke kanaka, ke alakaʻi nei i ka nui o ke kaʻina hana a me ka hoʻokuʻu koke o ke kino mai nā paʻakai a me ka wai. No laila, ʻo ka kaanaki ʻana o ka ʻōnaehana holoʻokoʻa, vasoconstriction a me ka hoʻohaʻahaʻa ʻana i ke kahe e hele ana.

Hoʻomaʻamaʻa pinepine ʻia nā diuretics i ka mālama ʻana i ka maʻi hypertension, akā i kekahi manawa ke lawe ʻia nei e nā mea maʻi me ka cirrhosis o ka ate a me nā poʻe e hōʻeha nei i ka ʻōpū o nā wāwae (ʻo ia paha kekahi o nā hōʻailona hemahema o ka hiki ʻole o ka naʻau).

Akā ʻo nā kānaka me ka maʻi maʻi, diuretics e hoʻohana pono me ka makaʻala loa, ma lalo o ka mākaʻikaʻi paʻa ʻana o kahi kauka, a hoʻomanaʻo hoʻi ʻaʻole pono nā mea āpau āpau i ka maʻi o lākou.

ʻAʻohe kīiʻi a me ka diuretise-sparing diuretics ʻaʻole kūpono no ka mālama piha o ka hypertension ma ka diabetes mellitus, akā hiki ke hoʻohana ʻia i hoʻokahi manawa, no ka hoʻokuʻu wikiwiki ʻana i kahi kūlana hōʻeha.

ʻO ka mea kaulana loa i ka mālama ʻana i ka maʻi hypertension i ka lā maʻamau i kēia mau thiazide a me ka diuretics like thiazide. Hoʻohana ʻia nā Thinzide diuretics, e like me ka dichlothiazide a me ka poithiazide i nā mea liʻiliʻi no ka mālama ʻana i ka maʻi hypertension ma ka maʻi diabetes type 2.

ʻO ka ʻoiaʻiʻo ʻo ia e hoʻemi i ka hoʻāʻo ʻana i nā ʻōnaehana i ka insulin. ʻO ka maʻamau ʻo ia wale nō e hana me ka hoʻohana mau ʻana a me ka hoʻohana mau ʻana i ka lāʻau lapaʻau, akā i kekahi manawa ke hana ʻia ma mua, i ke ʻano o ka hopena o ka hopena.

Ua hoʻohālikelike ʻia nā diuretics no ka mellitus maʻi diabetes no ka hoʻohaʻahaʻa ʻana i ka hypertension, e hōʻoluʻolu i ka huhū a mālama i ka hiki ʻole o ka naʻau. Pono e noʻonoʻo ʻia, ʻaʻole hiki ke hoʻohana ʻia nā diuretics no ka maʻi diabetes, ʻo ia ka mea pono iho o ka lāʻau ponoʻī a me ke koho ʻana o ka diuretics, me ka ʻole o ka mālama ʻana i kēia maʻi concomitant koʻikoʻi, hiki ke hoʻopilikia i ka pōʻino i ka kino.

No ka mālamaʻana i ka hapa nui o ka poʻe maʻi e loaʻa ana i ka hypertension arterial no ka manawa lōʻihi, e hoʻohana ana ka diuret thiazide, ka hoʻokipa ʻana i kahi e hiki ai i ka nalowale ikaika o ka sodium e ke kino. I ka manawa like, hoʻemi nui lākou i ka hoʻonaninaka ʻana o nā pūpuna i ka insulin, ʻo ia hoʻi e hoʻonui ka nui o ke koko o ka triglycerides, glucose a me ka kolamu, e kau ai i kekahi mau palena o ka hoʻohana ʻana o kēia mau diuretics no ka maʻi maʻamau ʻo 2.

Eia nō naʻe, ua hoʻokau nā noiʻi hou o ka hoʻohana ʻana i ka diuretics i ka maʻi mellitus i mālama ʻia i kēia mau hopena maikaʻi ʻole e nānā me nā kaha kiʻekiʻe o nā lāʻau lapaʻau. ʻO nā hopena haʻahaʻa - aneane ʻaʻole i hōʻike like.

Eia kekahi, ʻo nā mea maʻi me ka diabetes type 2, i ka wā e lawe ai i ka diuret thiazide, ua kauoha ʻia e ʻai i ka nui o nā huaʻai a me nā mea kanu hou, pono e uku no ka nalowale o ka pākuʻala o ka magnesium, sodium a me potassium.

ʻO ka hōʻemi ʻana o ka hoʻohaʻahaʻa ʻana i nā ʻike o nā ʻeneka i ka insulin e pono hoʻi e noʻonoʻo. I ka wā o ka mālamaʻana o ka hypertension, pinepine pono ia i ka mālama i ka pae o ke kō i loko o ke koko a, inā pono, hoʻonui i kona kō.

Ampoules

Hoʻomaopopo ʻia ke ʻano o ka diuretics i ka hapa nui i nā hihia koʻikoʻi inā hiki ke kūpono i ka hopena maikaʻi ke hiki koke mai ka manawa a hiki ʻole paha i ka mea maʻi ke lawe i ka lāʻau lapaʻau. ʻO nā lāʻau lapaʻau o nā koho he:

1. Hoʻohana ʻia ka bufenox injectable no ka hoʻokō intravenous a me ka intramuscular. Hiki ke kau ʻia ka nui o ka hopena mai ka 0.1 a hiki i ka 1.5 mg, hiki ke kiʻi ʻia ka hopena hou aʻe, e nānā ana i ka manawa o 4-6 hola. Pono ke ʻano o ka hopena therapeutic no nā lā ʻekolu a ʻehā paha.
2. Hoʻomoʻa kālā Ethacrylic. Kuhi ʻia ka ʻano o ka lāʻau lapaʻau no ka hoʻokō intravenous, ka pākīwau he 50 mg. ʻO ka hoʻomaka ʻana o ka hopena therapeutic hiki ke kali ma hope o 30 mau minuke, he mau no 8 mau hola.
3. Puʻu. Hiki ke hoʻohanaʻia ka hopena o ka hopena no ka hoʻokele intramuscular a me intravenous, aʻo ka pākaʻi ma waena o 20 a 40 mg. Hōʻike ka hopena i loko o kahi mau minuke a kū i 8 mau hola.
4. Lasix. Hoʻohana ʻia ia ma intravenously a intramuscularly. Me ka hoʻonuiʻana o ke koko, hiki ke loaʻa i nā lāʻau lapaʻau ʻelua ʻelua i ka lā.

ʻO nā manaʻo maikaʻi ʻole o nā lāʻau injectable o kēia hui, ʻike ʻia lākou i nā hōʻeha ʻeha e kū nei me ka hoʻomaka ʻana o ka lāʻau a me ka hiki ʻole o ka lawelawe kūlohelohe.

E ʻoluʻolu pono e kuhikuhi i ke ʻano o ke ʻano lāʻau a me kona mau lae e nā kauka, i ka nānā ʻana i nā ʻano o ka mea maʻi, ka ʻano a me ka ʻano nui o ka maʻi.

ʻO ka lōʻihi diuretic ka diuretic - ʻo 2 mau manawa lōʻihi ma mua o ka furosemide (no laila, ʻo ia ka mea maikaʻi loa o ka hui diuretics loop no ka mālama ʻana i ke ʻano o ka hypertension).

Ua ho'ākāka ʻia ka hopena diuretic ikaika e ka mea i piʻi i loko o kahi ʻāpana nui o ka loea Henle i hoʻohālikelike ʻia ka nui o ka sodium, a no laila ka wai, ua hoʻoiho ʻia. Kūpono ka diuretics e ka kahi hoʻokaʻawale ikaika i ke lumen o ka pāpaʻi proximal a hoʻokūkū me ka waikū uric no ka excretion, kahi e alakaʻi ai i kona lohi a me ka hypercuricemia.

Loaʻa ka loop diuretics kahi hopena hopena. ʻO ka hopena ʻelua o kēia ʻano o nā lāʻau lapaʻau ka mahuahua i ka hana o nā prostaglandins, e alakaʻi ana i ka vasodilation a hoʻomaikaʻi i ke koko i ka maʻi.

• kūlia
• hooulu serum creatinine,
• hipolopa,
• ʻohiʻala.

ʻO Ototoxicity (hōʻino i ka pepeiao) he hopena koʻikoʻi akā loaʻa ʻole ka hopena diuretics o ka loop diuretics. Hiki ke ulu ʻo Tinnitus a me ka dizziness, akā i nā hihia koʻikoʻi hiki ke alakaʻi ʻia i ke kuli.

No ka mea he diuretics loop e like me ka furosemide, torasemide a me ka bumetanide ma ka ʻenehana kīpona huehue (ʻike i ke kiʻi ma ka ʻano kemika o ka diuretics loop no kahi kiʻi), aia ka manaʻo pili i nā mea maʻi e pili ana i ka sulfanilamides e pili ana i ka diuretics loop.

Hōʻike ʻia kēia pilikia ma ka helu pūpū lāʻau. Eia nō naʻe, i ka mea maoli, ʻike ʻole i ka hopena o ka cross-reactivity, a aia kekahi mau kumu e kūʻē ana i ke ola ʻana o ia ʻano cross-reactivity.

Ua ʻike ʻia kekahi noiʻi ʻo 10% wale nō nā mea maʻi e maʻi aku i nā antibiotika sulfonamide ka cross-allergic i ka diuretics loop. Eia nō naʻe, ke kū nei nō ia i ka maopopo ʻole inā he ʻano cross-reactivity maoli a ʻokoʻa paha ke ʻano o ia ʻano.

ʻO ka acidacaclose wale nō ka lāʻau i loko o kēia papa o ka diuretics ʻaʻole i sulfanilamide. Eia nō naʻe, ua hoʻopiʻi ʻia kahi hoʻopiʻi e pili ana i nā hopena toxic ma ka gastrointestinal tract.

Hoʻopuka i ka diuretics i ka wā i hui pū me ka antibiotics aminoglycoside nui e hoʻonui i ka hōʻeha o ka ototoxicity koʻikoʻi (kuli hiki ʻole), anticoagulants e hoʻonui i ka hōʻeha o ke kahe, nā glycosides cardiac e hoʻonui i ka hōʻeha o ka arrhythmias,

nā lāʻau antidiabetic mai ka hui o derivatives o sulfonylurea - hoʻonui i ka hopena o ka hypoglycemia, NSAIDs - hōʻemi i ka hopena o ka hopena. Hoʻonui ka diuretics i ka hopena o ka propranolol a me ka hoʻomākaukau ʻana i ka lithium.

Hoʻohui ʻia diuretics

Hoʻopili ʻia nā diuretics i ka manawa like me ka hopena diuretic a me ka hoʻohaʻahaʻa koko. ʻO ka maikaʻi nui o kēia mau lāʻau lapaʻau ka hopena e loaʻa i nā hola 1-3 ma hope o ka hoʻokele ʻana a hoʻopaʻa ʻia mai 6 a 9 mau hola.

ʻO ka diuretics hui kaulana kaulana loa i loaʻa iā: Amirtid Mite, Triamtezid, Diazid, Isobar. Hoʻohana ʻia no ka toxicosis i ka wā hāpai, ke koko kiʻekiʻe a me ke ake ʻana o ka naʻau puʻuwai.

Hiki ke noʻonoʻo ʻia kēia ʻāpana hui ma ke ʻano o Apo-Triazide. Ke loaʻa nei kēia lāʻau lapaʻau i ka diuretic thiazide - hydrochlorothiazide a me ka diuretic pānaʻi pāhono - triampteren. Mahalo i kēia hui ʻana, ua hoʻokō ʻia ka hopena diuretic ikaika a ʻaʻohe pono no ka hoʻonui ʻana i ka potassium.

Hoʻohui pinepine ʻia nā lāʻau lapaʻau like ʻole i nā mea ʻelua a ʻoi aku paha i mea e hoʻomaikaʻi ai i ka hopena o kekahi, me ka hoʻēmi ʻana i nā hopena ʻaoʻao.No ka laʻana, ʻo ka lāʻau lapaʻau Apo-Azid i ʻelua mau mea hoʻoikaika - potassium-sparing triampteren (no ka pale ʻana i ka nalowale ʻana o kēia cation) a me kahi hydrochlorothiazide thiazide (e hoʻonui i ka pono o ka hopena).

Hoʻohana nui ka diuretics i ka mālama ʻana i ke koko koko kiʻekiʻe ma o ka hoʻohaʻahaʻa ʻana i ka nui o nā kahe e holo nei i nā moku. Ua heluhelu ka ʻano o ka diuretics i nā lāʻau lapaʻau e ʻokoʻa i ka hoʻonohonoho ʻana, nā lula o ka hana a me nā ʻano.

ʻAʻole ia e lawe e lawe iā lākou me ka loaʻa ʻole o kahi kauka a ke kauka, no ka mea e hiki ai kēia ke hōʻeha i ke olakino. Hoʻoholo ʻia ke koho o kahi diuretic e ke ʻano o ke ʻano o ka mea maʻi a me kona nānā ʻana i nā ʻāpana like o ka lāʻau. ʻO nā diuretics Thiazide e maʻamau maʻamau.

Lomi diuretics

Hoʻohana nui ʻia ka diuretics māmā i ka gynecology a me ka pīhoihoi i ka hakakā me ka hōʻā ʻana o nā lima a me nā wāwae i ka wahine hāpai, me ka hana maʻamau o ke kaila o ke koko kiʻekiʻe i nā keiki a me ka mālama ʻana i ka pākeke. Ma ka hihia mua, ma ke ʻano he diuretic palupalu, hiki ke hoʻohana ʻia nā lāʻau osmotic, no ka mea, ʻo kā lākou hopena koʻikoʻi ke kuhikuhi pono i ka wehe ʻana i nā kao mai nā kino edematous. Hoʻomaʻamaʻa pinepine ʻia nā keiki a me nā ʻelemakule i ka diuretics potassium-sparing as a diuretic nāwaliwali, aia i ka nui o nā hihia ke lawa ka wā e pono ai e hoʻohaʻahaʻa i ke koko o ke keiki ma ka 10-20 mm. I ka poʻe elemakule, ma muli o nā loli i ke kaʻina o nā hana biochemical, ma nā mea āpau e pili ana i ka diuretics maʻalahi, hiki iā lākou ke hāʻawi i ka hopena kūpono loa.

Pono e hoʻolōʻihi i ka hāʻawi i ka makemake i kēlā mau lāʻau i hāʻule ʻia ma lalo o ka helu ʻana o nā "māmā" a ʻaʻole i loaʻa nā hopena like ʻole o ka hoʻolālā hormonal, ʻo ia ka mea nui loa i ka wā e hele mai ai nā keiki ʻōpio a me nā wahine hāpai. Eia kekahi, hiki i nā infusion o nā mea kanu ke hoʻopili ʻia i nā diuretics māmā.

Nā diuretics ikaika

ʻAʻole ia e like me nā diuretics māmā, ka mea i loko o ka lāʻau lapaʻau ma ka ʻano o nā infusions mai nā ʻano lāʻau like ʻole i hoʻohana ʻia no ka wā lōʻihi, ua hana like ʻia nā lāʻau diuretic synthetic like ʻole i kēia manawa, akā ua lilo i mea ākea i ka mālama ʻana i nā maʻi like ʻole.

I kēia lā, nā diuretics ikaika loa.

Hiki ke hoʻohanaʻia ka Lasix i ka makua a i ʻole. ʻO ka uku kūponoʻole o kēia pono hana, ʻo ia ka wikiwiki o ka hopena maikaʻi ma hope o kona hoʻohana. ʻO ka laʻana, inā i lawe lula ʻia ʻo Lasix, a laila e loaʻa ka hoʻomaikaʻi i loko o hoʻokahi hola, a me ka hoʻokele makua i loko o kekahi mau minuke. I ka manawa like, ʻo ka lōʻihi o kēia diuretic i ka wā e lawe waha ʻia i nā hola 8, a i ka wā i hāʻawi ʻia ai intravenously - ʻekolu wale nō.

ʻO ka hopena diuretic o kekahi lāʻau diuretic ikaika - Spironolactone, i hoʻohana ʻia no ka edema o nā ʻano ʻano like ʻole, me ka edema puʻuwai, kū pinepine ma ka lā 3 o ka lawe ʻana i ka lāʻau lapaʻau. Eia naʻe, hiki ke hōʻemi nui ʻia kēia manawa ma o ka leka ʻana iā Flurosemide a i ʻole Hypothiazide me Spironolactone.

Loaʻa ka lure i ke ʻano o kahi lāʻau maloʻo a ua manaʻo ʻia ʻo ia kekahi o nā diuretics ikaika loa i hoʻohana ʻia ma ka edema o ka lolo, ka māmā, ka puʻuwai a me nā ʻawaʻawa me nā barbiturates.

Hoʻohui ʻia diuretics

ʻO ka hui pū ʻana o ka diuretics e pili ana:

1. Vero-Triamtezid,
2. Diazide,
3. Diursan
4. Diursan Mite
5. Isobar
6. Lazilactone
7. Moduretic
8. Thialoride
9. Triam Co
10. Triampur compositum,
11. ʻO Triamlezid,
12. Triamtel
13. Lāpau kālā Furesis,
14. Furo Aldopur
15. Ecodurex
16. Aliʻi Waimana,
17. Amyloside
18. Amiloria,
19. Amiloride + Hanalei,
20. Amitrid,
21. Amitrid Mite
22. Apo triazide.

ʻO kēia āpau hoʻohui diuretics a me kahi hopena hypotensive a me ka diuretic.ʻO ka maikaʻi o nā lāʻau hoʻohui i ka wikiwiki o ka hoʻomaka ʻana o nā loli maikaʻi ma hope o ka lawe ʻana iā lākou (mai 1 a 3 mau hola) a mālama i ka hopena i loaʻa mai i 7 a 9 mau hola.

Hoʻohana pinepine ʻia ka diuretics no ka piha o ka venous insufficiency, toxicosis i nā hebedoma hope o ka wā hapai, ate cirrhosis, nephrotic syndrome, hōʻeha puʻuwai, ʻo ia hoʻi no ka hypertension arterial.

Diuretic-free kalaha

Hoʻomaʻamaʻa ʻia ka diuretics kalaiwa no kēlā mau maʻi i loaʻa i ke koko kiʻekiʻe e hui pū ʻia me osteoporosis. ʻO kēia kahi hana kūpono e pale aku ai i ka holomua o osteoporosis i nā maʻi, a ma muli o ke ʻano, ʻo ka ʻike ʻana i nā haʻalulu hou. ʻOi aku ka papa momona a me ka pālato hoʻohiʻona i ka diuretics e holo ai i ka calcium, aʻo ka diuretics thiazide, ma ke kū'ē ʻana, e hōʻemi i ka hoʻonui ʻana i nā puna o ka calcium ma ka pā. ʻO ia ke kumu i hoʻohuihui ʻia ai ʻo thiazide-like a me thiazide diuretics wale nō i nā mea maʻi me ka osteoporosis. Eia nō naʻe, pono nā diuretics mālama-calcium, ʻaʻole wale no nā kānaka e loaʻa ana i ka osteoporosis, akā, no nā poʻe ʻē aʻe e piʻi nui loa ana ka hoʻomake ʻana i ka hōʻeha ORA, no ka laʻana ka poʻe kahiko. Hōʻike nā haʻawina i nā poʻe e lawe ana i nā diuretics like-thiazide no ka mālamaʻana i ka maʻi hypertension e liʻiliʻi ka hiki ke loaʻa i nā pōpoki ma mua o nā mea i kuhikuhi ʻia i nā ʻano ʻē aʻe o ka diuretics.

Akā, ʻoiai nā mea i wehewehe ʻia o ka diuretic, ka mālama ʻana i ka calcium, hiki ke hoʻohālikelike ʻia i kekahi mau pūʻulu o ka maʻi, no ka mea e pili ana kā lākou intake me ka hoʻonui ʻana i ka pā o ka magnesium a me ka pāima mai ke kino, ʻo ia ka mea maʻi me ka hyperuricemia, gout, hypokalemia a me nā mea'ē aʻe ʻaʻole hiki ke kuhikuhi.

Hoʻopuka di Antihypertensive

ʻO kahi kuhikuhi e hoʻohiki ai i ka mālama ʻana i ka hypertension i loko o nā mea maʻi ka hoʻohana ʻana o ka diuretics hyotensive. A ʻo ka ʻike ʻaʻole wale ia i aneane hiki i nā mea āpau ke hoʻemi i ka hoʻonaninani ʻana, i kekahi mau mea ʻaʻole i haʻahaʻa loa i ka hoʻohana ʻana i nā lāʻau lapaʻau kūikawā i kuhikuhi ʻia no ka mālama ʻana i nā ʻano maʻi hypertension, akā ua hoʻohālikelike ʻia ka mālama ʻana me ka diuretics antihypertensive, no ka laʻana, me ka b blockers , ke kumukūʻai ka mea maʻi 9-15 manawa maʻalahi, ʻo ka mea nui, ka hāʻawi ʻana i ka mea maoli he pūʻulu o nā poʻe e hele nei i ka hypertension he penikala, ʻo ia ka waiwai kālā i ka nui o nā hihia ʻaʻole lākou e ʻae i ka uku hoʻolimalima. Ke olona i lapaau.

Ke lawe nei i ka diuretics, ke hoʻokō ʻia ka hopena hypotensive ma muli o ka manawa mua o ka mālama ʻana i ka hopena o ka nui o ka neʻe ʻana o ke koko a me ka hopena cardiac (e hoʻolōʻihi ʻia ka puna o ka sodium klorida), a ma hope o kekahi mau mahina i maʻamau ka kahe o ke koko, ʻo nā kīʻaha koko ma kēia manawa e hōʻemi i ka kūleʻa peripheral, a laila kākoʻo hopena antihypertensive loaʻa i ka wā mālama.

ʻO nā mea hoihoi i kēia kumuhana!

ʻO nā diuretics nā lāʻau lapaʻau e hoʻopuka i ka hopena diuretic. ʻO nā mea kaulana loa a i maʻamau pinepine ʻia i nā hui diuretic - thiazide a me ka diuretics like-thiazide. Hoʻopili pinepine ʻia ke kahua o nā noi o kēlā mau lāʻau i nā maʻi o nā pēpē a me nā koina o ka urinary, akā hoʻohana ʻia nō hoʻi e hoʻoponopono i nā kaulike wai-kumu a me nā kaulike wai-electrolyte. I kēia mau makahiki, ua ʻike lākou i kā lākou noi ma ka cardiology me ka pahuhopu e hoʻohaʻahaʻa i ke koko, a e hōʻemi ana i ka ukana ma ka puʻuwai.

Ka hana o ka hana, nā hōʻike e pili ana no ka hoʻohana ʻana o ka diuret thiazide.

I ka maʻamau maʻamau, hoʻohana ʻia nā lāʻau o kēia pūʻulu e mālama i ka maʻi o nā urinary a me nā pūnaehana urinary. Ke hana nei kēia mau lāʻau me ka ikaika maʻalahi, ke hōʻike nei ka hopena iā ia iho ma hope o hoʻokahi manawa a ʻekolu mau hola, a lōʻihi ka lōʻihi ma kahi o ka hapalua lā.ʻO ka hana o ka hana ka pale i ka hoʻohālikelike o ka sodium a me ka wai i loko o ka tubula renal proximal, ma kahi o ka hana i ka wā i hoʻopuka ʻia ai i loko o ka urine i kahi wikiwiki wikiwiki. Eia kekahi, hoʻoneʻe ka thiazide diuretics i ka excretion o ka calcium, me ka pākahi a me ka ikaika o ka hoʻokumu ʻana i ka waikū uric i loko o nā keiki.

Hōʻike ʻia kēia ʻano diuretics ma nā ʻano pili o kēia pilikia:

• ka leo edematous
• hypertension arertial, ʻaʻole i kāpae ʻia e nā ala maʻamau, e hōʻemi ana i nā ke kaha ikaika,
• ka huakai a me ka wīwī o ka puʻuwai hema.

Ua manaʻo ʻia nā lāʻau lapaʻau nui o kēia pūʻulu chlortiazide a me hydrochlorothiazide, ka hoʻomaka ʻana o ka hana kūpono a nā mea i loaʻa i nā hola mua, a hiki i kā lākou hopena i nā hola 12-13.

Nā hopena ʻaoʻao a me nā contraindications.

ʻO nā hopena ʻaoʻao kekahi o nā hana hoʻohiwahiwa liʻiliʻi liʻiliʻi, ʻoiai nā hoʻololi o ke kaohi o nā mea pākuʻi a me nā huaora. Pēlā nō hoʻi, ka hypokalemia (ke emi ʻana o ka paʻū o ka pāhana i loko o ke koko) i kekahi manawa i loaʻa mai ka hopena ʻaoʻao, i ka wā e hoʻolaʻa iki ʻia ka lāʻau a me nā mea kanu me nā manaʻo kiʻekiʻe o kēia ʻatikala (panangin, asparkum) i kau ʻia. Hiki iā ʻoe ke hoʻomaopopo i kahi emi pinepine o ka nui o ka sodium i ka plasma, a me ka hoʻonui ʻana i ka hoʻoweliweli ʻana o ka waikū uric. ʻO ka hope, ke huli nei i ka lāʻau o ka hoʻopili ʻana, a pili pū kekahi i nā parenchyma o ka lolo. Ma hope o ka pau ʻana o ka hoʻohana ʻana i kēia lāʻau lapaʻau, hoʻoikaika kino ʻokoʻa i ke kino holoʻokoʻa.

Inā lawe nā mea maʻi me ka diuretics i nā beta-blockers, a laila hiki ke hopena i kahi hopena'ē aʻe o ka glucose metabolism.

ʻO nā ʻano contraindications, penei:

• nā maʻi hui pūʻili
• ʻO nā maʻi kānana glomerular i loko o nā pūpū,
• i ka emi ʻana o ke kō o ka paʻakai a me ke kō ma ka lolo koko,
• hapai a me ka wā o ka umauma,
• maʻi kūlohelohe a i ʻole mololia i kekahi o nā mea o ka lāʻau.

I kēia mau lā, loaʻa i kahi lāʻau lapaʻau ka loaʻa mau o kēia mau lāʻau lapaʻau, hiki iā ʻoe ke kūʻai no ke kālā liʻiliʻi ʻole me ke kauka ʻana o kahi kauka. Eia nō naʻe, he mea nui loa ke kuhikuhi ʻia ke koho ʻana i kēia mau lāʻau lapaʻau e kekahi kauka kūpono, e hōʻike ana i ka nui o ka hopena, ka lōʻihi a me ka lōʻihi o ka ʻoihana. E hiki mai ana, e haʻi pōkole mākou iā ʻoe e pili ana i nā lāʻau lapaʻau nui mai kēia hui.

I kēia wā, loaʻa ka diuretika thiazide me ka hydrochlorothiazide, indapamide, chlortalidone, a me ka clopamide. E haʻi mākou iā ʻoe e pili ana i nā mea mua he ʻelua i nā kikoʻī ʻē aʻe.

Kuhi aku nā kauka i kēia lāʻau lapaʻau i nā maʻi me ka edema a me hypertension, inā ʻaʻole lākou i pili i nā helu o nā wahine hāpai, nā kahu hānai, a me nā ʻelemakule. Hoʻohana ʻia ia i nā mea maʻi me ka puʻuwai a me nā palupalu o ke akeʻai, me kahi predisposition i ka urolithiasis. Me ka hypertension, maʻamau ka pākaukau o kēlā me kēia lā he papa papa, me ka edema koʻikoʻi, hiki i kēia dosage ke piʻi i ʻehā papa i kēlā me kēia lā. No nā hopena maikaʻi, ka nausea, ka luaʻi, ka arrhythmia, nā hana hoʻokūkū, hiki ke hoʻokaʻawale ʻia nā maʻi like, akā hiki ke ʻōlelo ʻia he ʻano nui loa. I ka wā e lawe ai i kēia lāʻau lapaʻau, e aʻo ʻia e liʻiliʻi i ka kū ʻana i ka lā maka, ʻo ka mea lāʻau i hōʻala nui ai i ka ʻili o ke kanaka i ka radiation ultraviolet.

Hoʻohana kēia lāʻau kūleʻa no ke hypertension. E inu ana i ke kakahiaka i hoʻokahi lā. ʻO nā hopena ʻaoʻao ka nāwaliwali, ka nāhā, ke poʻo, ke kaumaha, nā ʻōpū o ka ʻōpū. Mai kiʻi i nā makuahine hāpai a lactating. Iloko o ka nui o ka laiki, ike ana, puka, kuewa, a me ka naau hoi i ike ole ai. I kēia hihia, pono ʻoe e kāhea i kahi ambulance a ma ka manawa like e inu i ka honi ʻokoʻa a hoʻāʻo e holoi i kou ʻōpū.

ʻO nā diuretics, a i ʻole diuretics, he hui nui loa nā lāʻau lapaʻau e hōʻemi ana i nā kumuwaiwai i loko o nā puʻu serous o ke kino a me nā ʻekepili ma o ka hoʻonui ʻana i ka hoʻonui ʻana i ka urine mai ke kino. Hoʻohana nui ʻia ka hoʻomākaukau ʻana o kēia pūʻulu i ka mālama ʻana i nā maʻi like ʻole, a ʻoi ka nui o kā lākou mau ʻano hua i kēlā me kēia makahiki.

Ka papa lāʻau

Aia kekahi ʻano like o ka papa inoa diuretic o nā lāʻau. Malia paha ka pololei loa o ia mau mea ka hoʻonohonoho ʻano honua o diuretics e ka hoʻokūkū o ka hana :

• nauwe
• diuretics non-thiazide e pili ana i ka māhele cortical o ka piko Heine,
• Hoʻomakai pālua ka paʻakai,
• nā diuretics loop
• nā hui o nā diuretic a me nā ʻaina paʻakai pālua.

Aia nō ka hoʻokaʻawale ʻana i nā diuretics ma muli o ka helu o ka hōʻike o ka hopena, ma ka lōʻihi o ka hana a ma luna o kona ikaika, ma ka ʻano hui kemikolo, etc.

Diuretika Non-thiazide

Ua kapa ʻia kēia ʻōpala'ōmaʻomaʻo like thiazide-like diuretics. ʻO ka mahele punahele kaulana loa ʻo ia ka indapamide. Loaʻa ia i ka hopena like me ka diuret thiazide, a hoʻohana ʻia e mālama i ka hypertension arterial. Ma nā lāʻau lapaʻau, hiki i ka indapamide ke loaʻa ma lalo o nā inoa Indap, Indopres, Acripamide, Retapres, Arifon, Pamid, Arindap.

Ma kahi o indapamide, hoʻohana pū ka chlortalidone (Oxodoline) ma ʻaneʻi.