Li-diuretics: ke eng, ke mefuta efe le hore na e sebetsa joang

Litaba

• 1. Li-diuretics tsa Thiazide
• 2. Liuretics tsa mothapo
• 3. Li-diuretics tse bolokang potasiamo
• 4. Li-diuretics tsa Osmotic
• 5. Carbonic anhydrase inhibitor diuretics

Diuretics ke litlhare tse ka sebelisoang u le mong kapa tse amanang le lintho tse ling tse mafolofolo, bakeng sa kalafo ea khatello e phahameng ea mali, ho ruruha ho bakoang ke mafu a pelo, liphio kapa sebete, hara tse ling.

Ho na le mefuta e 'maloa ea diuretics e fumanehang, joalo ka thiazides, loop, potassium-sparing, osmotic kapa carbonic anhydrase inhibitors, ka mekhoa e fapaneng ea ts'ebetso le ho sebetsa libakeng tse fapaneng tsa liphio, tse lokelang ho laeloa ho latela bothata bo lokelang ho phekoloa.

1. Li-diuretics tsa Thiazide

Li-diuretics li na le mochini oa tsona oa tšebetso thibelo ea reabsorption ea sodium karolong ea pele ea methapo ea liphio ea distal, e eketsa ho tsoa ha eona, hammoho le ho tsoa ha li-chloride le, ho isa tekanyong e nyane, ea potasiamo le magnesium, e leng se lebisang ho pheliso ea metsi. Lipheko tsena li na le matla a itekanetseng.

Mabitso a tloaelehileng / a khoebo: Mehlala e meng ea thiazide diuretics ke indapamide (Natrilix, Indapen, Flux), hydrochlorothiazide (Diurix, Hidromed) le chlorothalidone (Higroton).

Matšoao a kalafo: Ka kakaretso, li-diuretics sehlopheng sena li bonts'oa bakeng sa ho theola khatello ea mali le kalafo e sa foleng ea edema e amanang le congestive heart failure, ho thatafala ha sebete le lefu la liphio.

Litla-morao tse tloaelehileng haholo: Tse ling tsa litla-morao tse atisang ho hlaha nakong ea kalafo ka lithethefatsi tsena ke ho tsekela, ho opeloa ke hlooho, ho fokola, ho nyekeloa ke pelo, ho hlatsa, ho ba lehlaba, letšollo, ho sokela, cholecystitis, pancreatitis le mathata a mali le a letlalo.

2. Liuretics tsa mothapo

Loop diuretics e sebetsa ka ho thibela reaborption ea sodium lekaleng le nyolohang la leqhubu la Henle, e leng se lebisang phokotsong ea ho khutlisetsoa ha metsi ka maqhubu. Ntle le moo, litlhare tsena li na le litlamorao tse otlolohileng phallong ea mali, tse bakang vasodilation le ho fokotsa khatello ea methapo ea renal. Litlhare tsena li na le tšusumetso e matla ea ho ntša metsi ka potlako e khutšoane ea nako e khuts'oane

Mabitso a tloaelehileng / a khoebo: Furosemide (Lasix, Neosemid) ke mohlala oa loop diuretic e sebelisoang haholo. Ithute ho sebelisa le contraindications bakeng furosemide.

Matšoao a kalafo: Liureure tsa mokotla li bontšoa bakeng sa taolo ea edema e matla ea pulmonary le mefuta e meng e matla ea edema, ho hloleha ho matla ha renal le khatello ea methapo ea mali. Ntle le moo, li ka sebelisoa ho phekola hypercalcemia e matla, kaha e khothaletsa ho ntša metsi ka calcium.

Litla-morao tse tloaelehileng haholo: Tse ling tsa litla-morao tse ka hlahang nakong ea kalafo ke pherekano ea elektrolyte, ho felloa ke metsi 'meleng, hypovolemia, litekanyetso tse eketsehileng tsa creatinine le triglycerides maling, litlhaselo tsa gout le bophahamo ba molumo oa ho ntša metsi.

3. Li-diuretics tse bolokang potasiamo

Litlhare tsena li thibela ho tsoa ha potasiamo maemong a bolaoli ba distal e fetang ka har'a tubule le ka har'a phaephe e bokellang, e ka bang le ketso e khahlanong le aldosterone kapa e se nang eona.

Spironolactone ke mohanyetsi ea khethehileng oa aldosterone, ea sebetsang haholo sebakeng sa phapanyetsano ea aldosterone e itšetlehileng ka aldosterone le potasiamo, e fumanehang ka har'a methapo e hlahisitsoeng ke liphio mme e lebisa ho eketseha ha sodium le metsi, ha potasiamo e ntse e bolokiloe.

Mabitso a tloaelehileng / a khoebo: Mehlala e meng ea diuretics e bolokang potasiamo ke amiloride, e amanang feela le lintho tse ling tse sebetsang, le spironolactone (Aldactone, Diacqua). Sheba lintlha tse ling tsa kalafo ea spironolactone.

Matšoao a kalafo: Li-diuretics tse bolokang potasiamo li na le ts'ebetso e fokolang ea ho ntša metsi, ka hona, ha e sebelisoe hangata ho phekola edema kapa khatello ea mali, 'me hangata e amahanngoa le diuretics tse ling. Ts'ebetso ea eona e kopanetsoeng e eketsa phello ea "diuretic" le "antihypertensive" ho thiazide le loop diuretics.

Litla-morao tse tloaelehileng haholo: Tse ling tsa litlamorao tse mpe tse ka bang teng ke katoloso ea bophahamo ba lisele tsa 'mele, ho felloa ke metsi' meleng le hypernatremia.

4. Li-diuretics tsa Osmotic

Meriana ena e eketsa ho hlonepha ha glomerular filtrate, e hlohlelletsang motsamao oa metsi a kenang ka hare ho sele hore e be sebaka se kantle ho lisele le methapo, e hlohlelletsang diuresis e tšoailoeng, ka lebaka leo e fokotsa khatello ea kelello le edema le khatello e phahameng ea intraocular.

Mabitso a tloaelehileng / a khoebo: 20% ea Mannitol. Fumana hore na mannitol e sebelisoa joang.

Matšoao a kalafo: 20% ea mannitol e bontšoa bakeng sa kalafo ea edema ea masapo, glaucoma e matla, ho hloleha ha renal le ho itokisetsa ho buuoa ka ophthalmic.

Litla-morao tse tloaelehileng haholo: Tse ling tsa litlamorao tse mpe haholo tse ka hlahang ke ho nyekeloa ke pelo, ho hlatsa, ho nyoroa, ho opeloa ke hlooho, ho tsekela, ho thothomela, feberu, ho otla ha pelo, ho opeloa ke sefuba, hypernatremia, ho felloa ke metsi 'meleng, ho fifala ha pono, hives kapa khatello ea mali.

5. Carbonic anhydrase inhibitor diuretics

Meriana ena e thibela carbonic anhydrase, e leng enzyme e thusang motho ho sebetsana le lik'hemik'hale tse kenyelletsang ho futhumatsa carbon dioxide le ho theola carbonic acid. Ka lebaka leo, ho na le fokotseha ka acid e carbonic, e isang ho alkalinization ea moroto, ho kgothaletsa diuresis.

Mabitso a tloaelehileng / a khoebo:acetazolamide (Diamox). Fumana hore na u ka e sebelisa joang le hore na li-contraindications tsa Diamox ke eng.

Matšoao a kalafo: Carbonic anhydrase inhibitors e bontšoa bakeng sa kalafo ea glaucoma, alkalinization ea mosese, alkalosis ea metabolism le lefu le bohloko la lithabeng.

Litla-morao tse tloaelehileng haholo: Tse ling tsa litlamorao tse bohloko tse ka bang teng ke metabolism ea methapo, ho holisoa ha molumo oa mokelikeli o kantle ho sele, hyponatremia, hlooho e opang, ho otsela, ho nyekeloa ke pelo, ho hlatsa le ho felloa ke metsi 'meleng.