Mankhwala "Torcida": malangizo ntchito, maonekedwe, zikuchokera ndi ndemanga. "Torcida": malangizo ntchito (mapiritsi)

M'zaka zaposachedwapa, madokotala amakono ambiri anayamba mankhwala odwala awo mankhwala monga "Torcida". Malangizo ntchito zikuphatikizapo yekha deta ofunika kuti munthu wabwinobwino kutenga mankhwala, koma kwambiri musanagule kapena pambuyo kupeza kuyesa kuphunzira zambiri za chida ichi.

pharmacodynamics

Izi mankhwala ndi saluretic. Ndi udindo maganizo chopinga aimpso reabsorption ya soda ndi mankhwala enaake ayoni, zomwe zili akwera gawo la kuzungulira Henle, chimene anasonyeza mankhwala "torsida" malangizo Buku.

Pharmacokinetics

munthu, pambuyo makonzedwe mtsempha wa ndalama mwamsanga akuyamba kusonyeza zotsatira diuretic. Pankhaniyi kuchepetsa zotsatira za mankhwala akufotokozera mkati woyamba maola 3 ndipo kenako kusungidwa mpaka maola 12. Pa maziko a ntchito izi zikutanthauza diuresis mwachindunji amadalira mlingo, amene anasonyezanso mankhwala "torsida" malangizo Buku.

Torasemide digiri ya kumanga zonsezo plasma monga mkulu monga 99%, lomwe ndi zotsatira zabwino kwambiri, pamene metabolites M1, M3 ndi M5 umanena ankalemekeza pa 86,95 ndi 97%. Zolemba malire zotheka Kupha theka moyo wa torasemide ndi metabolites zosiyanasiyana mu wathanzi kuphunzira, kuyambira maola atatu kapena anayi, omwe anazindikiritsidwa mu njira ya mayesero matenda.

Total chilolezo cha mankhwala ndi 40 ml ya / min., Pamene mlingo chilolezo aimpso ndi za 10 ml / min. Metabolite M5 umabala ziribe mphamvu diuretic, pamene Kuphatikiza metabolites M3 ndi M1 nkhani pafupifupi 10% ya kanthu pharmacodynamic amagwiritsa ntchito pa thupi la munthu.

Features mankhwala anthu matenda osiyanasiyana

Ngati wodwala anaulula kulephera aimpso, zilibe bwanji ntchito chachikulu chilolezo ndi theka moyo wa torasemide, pamene kukula nyengo chifukwa metabolites M5 ndi M3. Pa nthawi yomweyo kusungidwa kwathunthu koyamba makhalidwe pharmacodynamic, koma nthawi ya kanthu mankhwala kulephera aimpso komanso alibe zotsatira, kaya cha zovuta matenda.

Mu odwala amene nacho chiwindi kukanika, kapena ndi mtima kulephera, kangapo kuchuluka metabolite excretion wa torasemide ndi M5, amene anasonyeza mankhwala "Torcida" malangizo Buku.

Kuchuluka kwa mankhwala mu linanena bungwe mkodzo ndi pafupifupi kwathunthu limafanana ndi kuchuluka kwa zimene anaona mu odzipereka wathanzi, mogwirizana ndi iyeyo torasemide ndi metabolites ake sakhala cumulate.

umboni

Nthawi zambiri zaphindu yogwira mankhwala kwapatsidwa mwa madokotala mankhwalawa exudates zosiyanasiyana kapena edema kuwonekera mogwirizana ndi kulephera mtima. Tikumbukenso kuti mankhwala "Torcida" malangizo ntchito (mapiritsi) chimasonyeza kuti Kwalamulidwa, ngati n'koyenera, muyezo mankhwala.

contraindications

Pali zina zimene kugwiritsa ntchito mankhwala ndi sanali analimbikitsa kapena zoletsedwa palimodzi. Analongosola iwo Ufumuyo mankhwala "Torcida" malangizo ntchito (mapiritsi - ankaona mawonekedwe a), ndi kupereka zina zazikulu:

• pamaso pa odwala wolumikizira hypotension;
• tilinazo kuchuluka kwa zinthu zosiyanasiyana wothandiza kapena mphamvu, komanso sulfonylureas ena;
• osavomerezeka chifukwa odwala matenda a impso kulephera ndi anuria;
• ndi ntchito aakulu chiwindi;
• mitundu yonse ya kuyan'anila za madzi electrolyte dongosolo bwino;
• gout;
• Ngati wodwala akudwala matenda aakulu mu dongosolo mkodzo;
• mitundu yonse ya kuyan'anila za conductive dongosolo digiri yapamwamba ya mtima;
• kusintha pathological mu chithunzi chonse magazi ndi asidi-m'munsi udindo wa munthu;
• chisokonezo kugwira ntchito kwa impso chifukwa zotupa nephrotoxic zinthu zosiyanasiyana.

Mwa zina, iwo ali osavomerezeka ntchito chida ichi kwa akazi amene amakhala mu nthawi ya mimba kapena mkaka wa m'mawere.

Bwanji ntchito?

Ngati mukufuna kugwiritsa ntchito madzi mawonekedwe, wothandizila ayenera kuperekedwa kokha kudzera m'mitsempha pang'onopang'ono, umboni ndi mankhwala "Torcida" malangizo Buku. Mtengo wa chida (kuchokera rubles mazana asanu) ndi mwachilungamo Kufikika choncho anthu ambiri pasakhale mavuto kuti kutsatira bwino ndi zizindikiro ntchito zake.

Koyamba umodzi mlingo ndi za 10 mg pa tsiku, i.e. 2 ml kukonzekera izi. Ngati pali pang'ono matenda phindu, ndiye mlingo akhoza ziwonjezeke kawiri. Koma ngati sizingatheke kukwaniritsa Mwachangu yoyenera, ndiye mlingo akhoza ziwonjezeke ngakhale kawiri, koma chithandizo ayenera mpaka munthu pazipita masiku atatu.

Pachimake m'mapapo mwanga edema

Pamene ntchito wothandizila izi akuchiritsa pachimake m'mapapo mwanga edema, poyambira mlingo ndi 20 mg, pamene malinga okwana chithunzi matenda a mankhwalawa akhoza kutumikiridwa aliyense theka la ora. Tikumbukenso kuti zimenezi mlingo okwana sayenera upambana mamiligalamu 100 pa tsiku torsemide.

Pakuti malangizo mankhwala tikulimbikitsidwa monga njira zambiri kuposa sabata, amenenso zinasonyeza kuti mankhwala "Torcida" malangizo ntchito angagwiritsidwe ntchito kusinthana kwa makonzedwe m'kamwa ngati mtsempha sayenera kugwiritsidwa ntchito. Price (ndemanga titsimikizire kuti) ngati cholembapo chathabwa ndipo chinthu madzi mosavuta ambiri, choncho kwathunthu mankhwala kawirikawiri amayambitsa vuto. Mulimonsemo, pazipita zotheka tsiku mlingo sayenera upambana 100 mg.

kwa chiwindi kulephera

Pankhani ya njira odwala ndi kuwonongeka kwa chiwindi ayenera ntchito mosamala pazipita, monga mu nkhani iyi pali chiopsezo kuchuluka kwa torasemide mu zikuchokera kwa madzi a m'magazi. Iwo amatchuka payokha mankhwala "torsida" (10 mg) mu malangizo Buku (piritsi kapena madzi kukonzekera mawonekedwe - moperewera).

okalamba

Zochizira odwala awa sasamalira munthu njira mu kusankha mlingo. Dziwani kuti palibe lalikulu matenda maphunziro pa kufanana kwa njira ya mankhwala achinyamata ndi okalamba anthu si ikuchitika, choncho ndi bwino nthawi zonse kufunsa nanu dokotala chisanadze oyenerera.

yankho A jekeseni ayenera pang'onopang'ono kutumikiridwa m'nsinga, ndipo motero pali Mulimonsemo osati intraarterially zomwe zikutsindika payokha mankhwala "torsida" malangizo ntchito (ampoules).

zotsatira zoyipazi

Dziwani chakuti zochita chowawa zingakhudze Inde ziwalo zambiri, choncho iliyonse tidzakambirana payokha:

• Zamtima dongosolo. Pankhaniyi, pamene akumwabe mankhwala akhoza kupezeka matenda osiyanasiyana a madzimadzi ndi electrolyte bwino, pamene ena nthawi zina komanso kuchuluka kagayidwe kachakudya alkalosis. Komanso, mu magawo ena odwala kukhala chisokonezo, thrombosis, hypotension, oziziritsa ndi mtima ischemia, pachimake m'mnyewa wamtima infarction, angina ndi syncope.
• Mantha dongosolo. Nthawi zina, makamaka pa siteji oyambirira chithandizo, pangakhale mutu, kutopa kwambiri, chizungulire, ndi kukokana kwa minofu.
• Dongosolo m'mimba. Nthawi zina, mwina matenda panopa dongosolo m'mimba mu ndondomeko ya momwe ntchito mankhwala "Torcida". Malangizo ntchito linanena zotsatira zotsatirazi mbali: nseru, kusafuna kudya, kusanza, kutsekula m'mimba, kupweteka m'mimba. Zingakhalenso pano mopambanitsa kuchuluka kwa michere kwa chiwindi.
• Dongosolo mkodzo. Odwala amene ali ndi chisokonezo zosiyanasiyana m'dongosolo pokodza, pali pokodza mwachilungamo kwambiri, chimene chingalowe mapeto akuchedwa ndi Tambasula amphamvu kwambiri chikhodzodzo. Nthawi zina, izo zingakhale mpweya mlingo wa creatinine ndi urea m'magazi.
• Kagayidwe. Nthawi zina, odwala olembedwa kuwonjezeka mu mulingo wonse wa asidi uric, lipids ndi shuga m'magazi.
• dongosolo la mwazi. Nthawi zina kwambiri, yafupika chiwerengero cha erythrocytes, leukocytes ndi maselo othandiza magazi kuundana.
• The chitetezo. Nthawi zina, totupa, photosensitivity, pruritus. Ndi mankhwala "torsida" (jakisoni) malangizo ntchito zikusonyeza kuti nthawi zina pambuyo makonzedwe mtsempha angayambe kukhala ndi zochita pachimake hypersensitivity, limene mtima wa maximally thandizo kudya ayenera kupatsidwa. Nthawi zina, mungachite zochita khungu.

Ngati ife kulankhula za polojekitiyi zazing'ono, ndi paraesthesia yosowa ndi pakamwa youma. Komanso mwapadera ziperekedwe chakuti mu nthawi zina kwambiri anthu pali ena kuwonongeka zithunzi, komanso zikamera wa tinnitus, kapena imfa wathunthu mmakutu.

ambiri osokoneza

Zizindikiro lililonse milandu mankhwala ambiri osokoneza bongo pa nthawi yosadziwika. Buku limasonyeza kuti chochitika cha mankhwala osokoneza bongo akhoza kupezeka mokwanira amphamvu diuresis, ndi chiopsezo cha mavuto aakulu a electrolytes ndi madzi, kugona ndi matenda amential. Mwa zina, ndi ambiri osokoneza zimachitika kulephera mtima, hypotension ndi matenda osiyanasiyana, kapepala kakuti m'mimba.

Kodi kuchitira?

Iliyonse yothetsera zenizeni kwa mphindi alibe chawululidwa. Nthawi zambiri, matendawo chifukwa kuledzera, kutha kwathunthu pambuyo kuchepetsa mlingo kapena kuwonongedwa kwathunthu kwa ntchito za mankhwala, ndipo ngati n'kotheka electrolytes chimathandiza ndi madzi adzakhala anapereka, zimene ziyenera kuchitidwa m'mikhalidwe kulamulira pazipita. Torasemide zili zosatheka opangidwa kuchokera ku magazi ndi hemodialysis.

Izi ndi mfundo zazikulu za "Torcida" kukonzekera (malangizo ntchito, mtengo, ndemanga). Analogs cha chida ( "Britomal", "Sutrilneo") nthawi zambiri amasiyana ofanana kanthu ndi mankhwala, koma ndi njira madokotala zambiri kukachita mmodzi wa yabwino kwambiri mu gulu ake.