Diuretics: lawv yog dab tsi, hom twg thiab lawv ua haujlwm li cas

Zoo Siab

• 1. Thiazide diuretics
• 2. Ntxees diuretics
• 3. Cov poov tshuaj-sparing diuretics
• 4. Osmotic cov tshuaj tso zis
• 5. Carbonic anhydrase inhibitor diuretics

Diuretics yog cov tshuaj kho mob uas tuaj yeem siv ib leeg los yog txuam nrog lwm yam tshuaj, rau kev kho mob ntshav siab, o tshwm sim los ntawm kev mob plawv, raum lossis mob siab, nrog rau lwm tus.

Muaj ntau hom diuretics muaj, xws li thiazides, lub voj voos, potassium-sparing, osmotic lossis carbonic anhydrase inhibitors, nrog cov txheej txheem sib txawv ntawm kev ua thiab kev coj ua hauv thaj tsam sib txawv ntawm lub raum, uas yuav tsum tau tsim nyob ntawm qhov teeb meem yuav tsum tau kho.

1. Thiazide diuretics

Cov diuretics muaj raws li lawv cov kev ua ntawm kev txiav txim siab hauv kev txiav txim siab ntawm sodium reabsorption hauv thawj feem ntawm lub raum tub menyuam, ua kom nws txoj kev nthuav dav ntxiv, nrog rau cov tshuaj tsis haum ntawm chlorides thiab, rau qhov tsawg dua, ntawm cov poov tshuaj thiab magnesium, uas yog li ua tshem tawm cov dej. Cov tshuaj no siv nrog kev sim me me.

Generic / coj mus muag npe: Qee cov piv txwv ntawm thiazide diuretics yog indapamide (Natrilix, Indapen, Flux), hydrochlorothiazide (Diurix, Hidromed) thiab chlorothalidone (Higroton).

Qhov taw qhia kho: Feem ntau, diuretics hauv chav kawm no yog qhia rau kev txo qis ntshav siab thiab rau kev kho mob ntev ntawm edema cuam tshuam nrog txhaws lub plawv tsis ua haujlwm, kab mob siab thiab lub raum.

Feem ntau cov kev mob tshwm sim: Qee qhov kev mob tshwm sim feem ntau uas tuaj yeem tshwm sim thaum kho nrog cov tshuaj no yog kiv taub hau, mob taub hau, tsis muaj zog, xeev siab, ntuav, mob plab, raws plab, cem quav, cholecystitis, pancreatitis thiab ntshav thiab tawv nqaij muaj mob.

2. Ntxees diuretics

Ntxees diuretics ua los ntawm inhibiting sodium reabsorption hauv ascending ceg ntawm lub voj ntawm Henle, ua rau txo qis rau tubular dej reabsorption. Tsis tas li ntawd, cov kev hais daws no tseem cuam tshuam ncaj qha rau cov ntshav khiav, ua rau vasodilation thiab txo hlaus pob voos tsis kam. Cov kev kho no muaj lub zog diuretic muaj txiaj ntsig, nrog kev pib sai sai ntawm lub sijhawm luv

Generic / coj mus muag npe: Furosemide (Lasix, Neosemid) yog ib qho piv txwv ntawm cov diuretic uas siv dav dav. Kawm siv yuav ua li cas thiab dab tsi contraindications rau furosemide.

Qhov taw qhia kho: Ntxees diuretics raug qhia rau kev tswj hwm ntawm cov mob ntsws qhuav thiab lwm yam tsos mob qis qis, mob raum tsis ua haujlwm thiab mob ntshav liab. Tsis tas li, lawv kuj tuaj yeem siv los kho tus mob hypercalcemia, vim lawv txhawb txoj kev tso zis tso zis.

Feem ntau cov kev mob tshwm sim: Qee qhov kev mob tshwm sim thaum lub sijhawm kho yog electrolyte cuam tshuam, lub cev qhuav dej, hypovolemia, muaj ntau ntawm creatinine thiab triglycerides hauv cov ntshav, gout tawm tsam thiab tso zis ntau ntxiv.

3. Cov poov tshuaj-sparing diuretics

Cov tshuaj no thaiv txoj kev tsis haum ntawm cov poov tshuaj ntawm lub davhlau ya nyob twg ntawm distal bypassed tubule thiab hauv cov raj ntim khaws, uas yuav yog lossis tsis muaj kev tiv thaiv aldosterone antagonistic.

Spironolactone yog ib qho tshwj xeeb aldosterone antagonist, ua yeeb yam feem ntau ntawm aldosterone-dependant sodium thiab potassium ion pauv chaw, nyob hauv lub distal qhia lub raj ntawm lub raum thiab ua rau kom muaj ntau ntxiv sodium thiab dej yuav tsum tau tawm, thaum cov tshuaj potassium khaws cia.

Generic / coj mus muag npe: Qee cov piv txwv ntawm cov tshuaj potassium-sparing diuretics yog amiloride, uas tsuas yog cuam tshuam nrog lwm cov tshuaj uas muaj sia, thiab spironolactone (Aldactone, Diacqua). Saib lwm cov cim qhia kev kho mob rau spironolactone.

Qhov taw qhia kho: Potassium-sparing diuretics muaj qhov ua kom tsis muaj zog diuretic thiab, yog li ntawd, tsis tshua muaj siv nyob rau hauv kev kho mob ntawm edema lossis mob ntshav siab, thiab feem ntau cuam tshuam nrog lwm cov diuretics. Nws txoj kev sib koom tes nce cov diuretic nyhuv thiab antihypertensive teb rau thiazide thiab voj diuretics.

Feem ntau cov kev mob tshwm sim: Qee qhov kev tsis zoo tshwm sim uas tuaj yeem tshwm sim yog nthuav cov ntim ntxiv, lub cev qhuav dej thiab hypernatremia.

4. Osmotic cov tshuaj tso zis

Cov tshuaj no nce osmolarity ntawm glomerular filtrate, uas ua kom muaj kev txav ntawm dej intracellular mus rau qhov chaw ua haujlwm ntxiv thiab vascular, inducing cim diuresis, thiaj li txo qis intracranial siab thiab edema thiab siab intraocular siab.

Generic / coj mus muag npe: 20% Mannitol. Txheeb xyuas seb mannitol siv li cas.

Qhov taw qhia kho: 20% mannitol yog qhia rau kev kho mob ntawm cerebral edema, mob txha caj dab, mob raum tsis zoo thiab npaj rau ophthalmic phais.

Feem ntau cov kev mob tshwm sim: Qee qhov kev tshwm sim ntau tshaj plaws uas tuaj yeem tshwm sim yog xeev siab, ntuav, nqhis dej, mob taub hau, kiv taub hau, tshee tshee, nce lub plawv dhia, mob hauv siab, hypernatremia, lub cev qhuav dej, plooj tsis pom kev, khaus lossis ntshav siab.

5. Carbonic anhydrase inhibitor diuretics

Cov tshuaj no inhibit carbonic anhydrase, uas yog ib qho enzyme uas catalyzes cov tshuaj lom neeg lub cev uas cuam tshuam nrog hydrating carbon dioxide thiab dehydrating carbonic acid. Raws li qhov tshwm sim, muaj qhov txo qis hauv cov carbonic acid, uas ua rau kom muaj cov alkalinization ntawm cov zis, txhawb cov diuresis.

Generic / coj mus muag npe:acetazolamide (Diamox). Tshawb nrhiav seb yuav siv li cas thiab qhov twg ntawm contraindications rau Diamox yog.

Qhov taw qhia kho: Carbonic anhydrase inhibitors yog qhia rau kev kho mob ntawm lub ntsej muag, mob tso zis tso zis, cov kab mob metabolic alkalosis thiab mob roob.

Feem ntau cov kev mob tshwm sim: Qee qhov kev tshwm sim tsis zoo uas tuaj yeem tshwm sim yog cov teeb meem metabolic acidosis, nthuav dav ntawm cov kua dej ntxiv, tso kua mis, mob taub hau, tsaug zog, xeev siab, ntuav thiab lub cev qhuav dej.