I-diuretics: Ukusetshenziswa, imikhiqizo ejwayelekile, nolwazi lokuphepha
Imininingwane YezidakamizwaUhlu lwama-diuretics | Yini i-diuretics? | Basebenza kanjani | Isebenzisa | Izinhlobo | Ubani ongathatha isisu? | Ukuphepha | Okuqhamuka uma udla imishanguzo | Izindleko
I-diuretics, eyaziwa kakhulu ngokuthi amaphilisi amanzi, inyusa inani loketshezi olukhishwa emzimbeni ngomchamo. Enye yezinto ezaziwa kakhulu, isisu semvelo yi-caffeine, evame ukutholakala ekhofi nasetiyeni. Kodwa-ke, i-caffeine inemiphumela emincane yokuhambisa isisu futhi ayijwayele ukusetshenziswa njenge-diuretic kuzilungiselelo zezokwelapha.
Umlando wanamuhla wama-diuretics uqale ngo Ngo-1919 lapho umfundi wezokwelapha ethola ukuthi imijovo equkethe imercury iyasebenza ekukhipheni amanzi ezigulini zikagcunsula. Bekuze kube yilapho i- Ama-1950s nango-1960 ukuthi kwatholakala ama-thiazide nama-loop diuretics asetshenziswa kakhulu futhi asetshenziswa kabanzi. Namuhla, i-diuretics imiselwe ukunakekelwa kwengcindezi ephezulu yegazi nezinye izimo.
Qhubeka ufunde ukuze ufunde kabanzi ngezinhlobo ezahlukahlukene zesisu, ukusetshenziswa kwazo, nemiphumela engemihle.
| Uhlu lwama-diuretics | |||
|---|---|---|---|
| Igama lomkhiqizo (igama elejwayelekile) | Intengo yemali emaphakathi | Intengo ye-SingleCare | Funda kabanzi |
| I-Microzide (i-hydrochlorothiazide) | $ 56 per 30, 25 mg amaphilisi | Thola amakhuphoni e-hydrochlorothiazide | Imininingwane ye-Hydrochlorothiazide |
| I-Hygroton (chlorthalidone) | $ 31 per 30, 25 mg amaphilisi | Thola amakhuphoni e-chlorthalidone | Imininingwane yeChlorthalidone |
| I-Lozol (indapamide) | $ 46 per 30, 2.5 mg amaphilisi | Thola amakhuphoni e-indapamide | Imininingwane ye-Indapamide |
| I-Zaroxolyn (metolazone) | $ 105 per 30, 2.5 mg amaphilisi | Thola amakhuphoni e-metolazone | Imininingwane ye-Metolazone |
| I-Bumex (bumetanide) | $ 91 per 30, 1 mg amaphilisi | Thola amakhuphoni e-bumetanide | Imininingwane yeBumetanide |
| I-Lasix (furosemide) | $ 26 per 30, 20 mg amaphilisi | Thola amakhuphoni e-furosemide | Imininingwane kaFurosemide |
| I-Demadex (torsemide) | $ 35 per 30, 20 mg amaphilisi | Thola amakhuphoni we-torsemide | Imininingwane yeTorsemide |
| I-Edecrin (i-ethacrynic acid) | $ 95 per 4, 25 mg amaphilisi | Thola amakhuphoni e-ethacrynic acid | Imininingwane ye-Ethacrynic acid |
| I-Midamor (amiloride) | $ 42 per 30, 5 mg amaphilisi | Thola amakhuphoni e-amiloride | Imininingwane ye-Amiloride |
| I-Dyrenium (triamterene) | $ 478 per 30, 50 mg amaphilisi | Thola amakhuphoni we-triamterene | Imininingwane ye-Triamterene |
| I-Aldactone (spironolactone) | $ 30 per 30, 25 mg amaphilisi | Thola amakhuphoni e-spironolactone | Imininingwane ye-Spironolactone |
| I-Inspra (eplerenone) | $ 235 per 30, 25 mg amaphilisi | Thola amakhuphoni e-eplerenone | Imininingwane ye-Eplerenone |
Nezinye isisu
- I-diuril (i-chlorothiazide)
- I-Naturetin (bendroflumethiazide)
- I-Enduron (methyclothiazide)
- I-Renese (polythiazide)
- I-Saluron (hydroflumethiazide)
- I-diamox (i-acetazolamide)
- I-Daranide (dichlorphenamide)
- I-Neptazane (methazolamide)
- I-Diurex (pamabrom)
- I-Osmitrol (mannitol)
Yini i-diuretics?
Ngaphandle kwalokho kwaziwa njengamaphilisi amanzi, isisu yimithi ekhulisa inani likasawoti namanzi akhishwe emzimbeni. Le mithi inyusa ukukhiqizwa komchamo okhiqizwe ezinso, okuholela ekwandeni kokugeleza komchamo, noma i-diuresis. I-diuretics ijwayele ukusetshenziselwa ukwelapha umfutho wegazi ophakeme (umfutho wegazi ophakeme) nokugcina uketshezi, noma i-edema, okuvela njengophawu lokwehluleka kwenhliziyo, izinkinga zezinso, nokwehluleka kwesibindi. Amanye ama-diuretics angasetshenziswa ukwelapha ukuvuvukala ebuchosheni okubangelwa ukulimala kanzima ekhanda noma ukuvuvukala emehlweni okubangelwa izimo zamehlo ezifana i-glaucoma .
Isebenza kanjani i-diuretics?
I-diuretics isebenza ngokuguqula ibhalansi yamanzi, usawoti, nama-electrolyte emzimbeni.
Ngokuqondile, zinemiphumela ezinqubeni ezahlukahlukene ezinso ezidlala indima ekubuyiselweni kabusha kwe-sodium ne-electrolyte. Kunezinhlobo ezahlukahlukene zesisu. Ngamunye wabo angasebenza ezingxenyeni ezihlukile ze- izinso , isitho sokuhlunga somzimba. Ngenxa yokwanda kokuhlushwa kwe-sodium ekhishwe ezinso, amanzi amaningi akhishwa emzimbeni emchameni.
Kungabalulekile ukuqonda ukwakheka kwezinso nokuthi kusebenza kanjani ukuqonda ngokuphelele ukuthi isisu sisebenza kanjani. Inso ngalinye liqukethe ngaphezulu kwesigidi esisodwa nephrons, okuyizinto zokuhlunga ezisusa imfucuza futhi zikhiqize umchamo emzimbeni. Ngokuya ngohlobo lwe-diuretic, le mithi ngokuvamile isebenza ku-tubule ehlanganisiwe, isitho esikhuphukayo se-loop kaHenle, i-distal convoluted tubule, noma i-tubule yokuqoqa.
Yenzelwa i-diuretics?
I-diuretics ingasetshenziselwa ukwelapha izimo ezahlukahlukene ezithinta inhliziyo, izinso nesibindi. Zisetshenziswa futhi njengama-antihypertensives ukwehlisa umfutho wegazi. I-diuretics kwesinye isikhathi ihlukunyezwa yilabo abanenkinga yokudla ukuze banciphise isisindo. I-diuretics ingatholakala kuphela ngemithi kadokotela futhi ingasetshenziselwa ukwelapha okulandelayo:
- Ukwehluleka kwenhliziyo
- Ukwehluleka kwe-ventricular kwesokunxele
- Umfutho wegazi ophezulu
- Ukwehluleka okukhulu kwezinso
- Ukwehluleka kwezinso ze-Oliguric
- Amatshe ezinso
- Ukulimala kanzima kwezinso
- Isifo sezinso
- Isifo sesibindi
- I-edema yamaphaphu
- Amazinga aphezulu we-calcium yegazi (hypercalcemia)
- Izinga eliphakeme le-potassium yegazi (hyperkalemia)
- I-Nephrogenic diabetes insipidus
- Ingcindezi High intracranial
- I-Glaucoma
Izinhlobo zomchamo
Izidakamizwa ze-Thiazide
I-Thiazides ikhombe i-sodium-chloride cotransporter ukuvimba ukubuyiselwa kabusha kwe-sodium, esiza ukulawula amazinga e-sodium nawomfutho wegazi. Njengesigaba sezidakamizwa, i-thiazide diuretics ivimbela ukubuyiselwa kabusha cishe 5% ye-sodium ku-distal tubule ekhonjiwe. I-Thiazides ibuye ivimbe ukubuyiselwa kabusha kwe-potassium, okungaholela ekususweni ngokweqile kwe-potassium emzimbeni. Amazinga aphansi e-potassium (I-hypokalemia) ingaholela kwizigqi zenhliziyo ezingavamile, phakathi kwezinye izinkinga. Ngenxa yemiphumela yabo, ama-thiazide avame ukusetshenziselwa ukwelashwa komugqa wokuqala we-hypertension esikhundleni se-ACE inhibitors. Izibonelo zama-thiazide zifaka phakathi i-Microzide (i-hydrochlorothiazide) ne-Hygroton (chlorthalidone).
I-Loop diuretics
Njengama-thiazide, i-loop diuretics nayo isiza ukulawula amazinga e-sodium ezinso. Kodwa-ke, i-loop diuretics isebenza engxenyeni ekhuphukayo yeluphu likaHenle ku-nephron. Le mithi ihlose i-sodium-potassium-chloride cotransporter ukuvimba ukubuyiselwa kabusha kwe-sodium namanzi. I-Loop diuretics nayo inganciphisa ukumuncwa kwe-potassium, okungaholela emazingeni aphansi e-potassium emzimbeni. I-Loop diuretics ingasetshenziselwa ukwelapha ukwehluleka kwenhliziyo, ukwehluleka kwezinso, amazinga aphezulu e-potassium (hyperkalemia), amazinga aphezulu e-calcium (hypercalcemia), nezinhlobo eziningi ze-edema, njenge-edema ye-pulmonary. Izibonelo ze-loop diuretics zifaka I-Bumex (i-bumetanide) ne-Lasix (i-furosemide) , kanye neDemadex (torsemide).
Ama-diuretics asindisa i-potassium
I-poture-sparing diuretics ayibangeli ukwanda kwe-potassium emcinini. Ama-diuretics asindisa i-potassium afana ne-amiloride abopha iziteshi ze-sodium ukunciphisa ukubuyiswa kabusha kwe-sodium egazini. Lokhu kwandisa ukulahleka koketshezi ngaphandle kokuncipha kwamazinga e-potassium. Amanye ama-diuretics asindisa i-potassium afana ne-spironolactone ku-distal tubule nokuqoqa amapayipi ukuvimba imiphumela ye-aldosterone, i-hormone ye-steroid ekhulisa ukubuyiselwa kabusha kwe-sodium. Izibonelo ze-potassium-sparing diuretics zifaka iMidamor (amiloride), iDyrenium (triamterene), i-Aldactone (i-spironolactone), ne-Inspra (i-eplerenone).
I-Carbonic anhydrase inhibitors
I-Carbonic anhydrase iyi-enzyme etholakala ezingxenyeni ezihlukene zomzimba, kufaka phakathi amaseli abomvu egazi kanye ne-proximal convoluted tubule yesinso. Le enzyme isiza umzimba ukuthi uphinde usebenzise i-sodium, i-bicarbonate ne-chloride. I-Carbonic anhydrase inhibitors ivimba le enzyme ukukhipha lezi zinto namanzi amaningi emzimbeni. I-Carbonic anhydrase inhibitors ivame ukusetshenziselwa ukwelapha i-glaucoma. Izibonelo zifaka phakathi iDiamox (acetazolamide) neNeptazane (methazolamide).
Nezinye isisu
I-Xanthine diuretics uhlobo lwe-diuretic emnene evimba ukubuyiselwa kabusha koketshezi ku-tubule esiseduze sezinso. Izibonelo ze-xanthine diuretics zifaka i-caffeine ne-Diurex (pamabrom). Izidakamizwa ze-Osmotic sebenzisa inqubo ye-osmosis ukudonsa uketshezi nokunciphisa ukugcinwa koketshezi. Ama-diuretics e-Osmotic asebenza ngokuyinhloko ku-tubule esiseduze kanye ne-loop kaHenle. I-osmotic diuretic esetshenziswa kakhulu yi-Osmitrol (mannitol), esetshenziselwa ukunciphisa ingcindezi yangaphakathi nokwelapha ukwehluleka okukhulu kwezinso.
Ubani ongathatha isisu?
Abantu abadala
Izidakamizwa zivame ukusetshenziselwa ukwelapha i-edema nezinye izimo zenhliziyo kubantu abadala. Ukusetshenziswa kwezidakamizwa kubantu abadala kuzoya ngesimo esiphathwayo.
Izingane
Izingane zinganikezwa ama-diuretics ukunciphisa ukugcwala ngokweqile kubangelwa ukuhluleka kwenhliziyo nokuhluleka kwezinso. Ukusetshenziswa komchamo ezinganeni kuzoya ngesimo esiphathwayo. Umthamo we-diuretics ezinganeni uvame ukubalwa ngesisindo somzimba.
Ingabe i-diuretics iphephile?
Izidakamizwa ngokuvamile ziyimithi ephephile uma isetshenziswa njengoba kunqunyiwe. Ngenxa yemiphumela yabo emanzini, usawoti, nokubuyiselwa kabusha kwe-electrolyte, kungadala ukungalingani koketshezi kanye ne-electrolyte. Ukwehla oketshezi okweqile nakho kungaholela ekuphelelweni amanzi emzimbeni kwezinye iziguli. Amazinga aphansi e-potassium nawo angakhathazeka ngama-diuretics amaningi ngaphandle kwama-diuretics asindisa i-potassium.
Ukusetshenziswa okuhlangene kwe-diuretics ne-digoxin noma i-lithium kungadinga ukuqashwa noma ukugwenywa. Khuluma nomhlinzeki wezempilo mayelana nokunye ukuxhumana kwezidakamizwa okungenzeka kube nezidakamizwa.
Izazi zokwelapha ziyakhumbula
Azikho izikhumbuzo zamanje ze-diuretic kusukela ngoMashi 2021.
Imikhawulo ye-diuretics
Ungathathi isisu uma unenkinga yokungezwani komzimba nezithako kuma-diuretics. Ama-diuretics athile aqukethe i-sulfa, engadala ukusabela okweqile kubantu abaye babhekana nokungezwani komzimba nemithi ye-sulfonamide efana ne-sulfamethoxazole.
Abanye abantu asebekhulile bangadinga ukuqashwa ngenkathi bethatha isisu. I-diuretics ingakhuphula ubungozi besizungu noma iwele kubantu abadala ngenxa i-postension hypotension , noma ukwehla okusheshayo komfutho wegazi lapho ushintsha indawo yokuhlala nokuma.
Ungakwazi yini ukuthatha i-diuretics ngenkathi ukhulelwe noma uncelisa?
I-diuretics kwesinye isikhathi ibekwa ngesikhathi sokukhulelwa komfutho wegazi ophakeme noma wezimo zenhliziyo. Noma kunjalo, ukuphepha kwabo akuqinisekisiwe yizifundo. I-diuretics kufanele isetshenziswe kuphela uma izinzuzo zidlula izingozi. Ukweqiwa okuphezulu kwe-diuretics kungathinta ukunikezwa kobisi futhi kucindezele i-lactation kwabesifazane abancancisayo. Xhumana nomhlinzeki wezokunakekelwa kwezempilo ngezeluleko ngaphambi kokusebenzisa isisu ngenkathi ukhulelwe noma uncelisa.
Ingabe izinto ezilawulwa yi-diuretics?
Cha, isisu asizona izinto ezilawulwayo.
Imiphumela emibi ejwayelekile yokwelapha isisu
Imiphumela emibi kakhulu ye-diuretics ifaka:
- Ukuchama njalo
- Isiyezi
- Ubumhlophe
- Ukukhathala noma ukukhathala
- Ubuhlungu bekhanda
- I-Rash
- Amajaqamba emisipha
- Uhudo
- Ukungasebenzi kahle kwe-Erectile
- Ukwanda kwamazinga kashukela egazini
Imiphumela emibi ye-diuretics ifaka amazinga aphansi e-potassium, noma i-hypokalemia, engaholela kwizigqi zenhliziyo ezingavamile. Ngaphandle kokwelashwa, amazinga aphansi e-potassium angaholela ezinkingeni ezisongela impilo. Ama-diuretics okonga i-potassium mancane amathuba okudala lo mphumela oseceleni kepha esikhundleni salokho angadala amazinga aphezulu e-potassium (hyperkalemia). I-diuretics ingadala okunye ukungalingani kwe-electrolyte njengamazinga aphansi e-sodium (hyponatremia) namazinga aphansi e-calcium (hypocalcemia).
I-diuretics nayo ingadala ukoma komzimba ngenxa yokukhishwa kwamanzi amaningi. Izimpawu zokuphelelwa amandla kwamanzi zingafaka ukoma ngokweqile, ukudideka, nomchamo onombala omnyama.
Amanye ama-diuretics afana nama-thiazide angakhuphula okwesikhashana amazinga e-cholesterol.
Tshela udokotela wakho uma unomlando wanoma iyiphi yalezi zimo ezilandelayo ngaphambi kokusebenzisa isisu:
- Isifo sikashukela
- Gout
- Izinkinga zezinso
- Ukuphela kwamanzi emzimbeni
- I-Pancreatitis
- ILupus
- Izinkinga zokuya esikhathini
Khuluma nomhlinzeki wezokunakekelwa kwempilo ukuze ufunde ngeminye imiphumela engemihle engaba khona, izixwayiso, kanye nezinyathelo zokuqapha ezihambisana nezidakamizwa.
Kubiza malini i-diuretics?
Ama-diuretics imishanguzo eshibhile futhi engabizi kakhulu etholakala ngegama lomkhiqizo nangohlobo olujwayelekile. Cishe wonke ama-Medicare nezinhlelo zomshuwalense zizofaka isisu. Izindleko zingahluka ngokuya ngohlelo lwakho lomshuwalense. Ngaphandle komshwalense, izindleko zesisu zingahluka ngokuya ngobungako bamaphilisi abekiwe. Noma kunjalo, usebenzisa i- ikhadi lesaphulelo somuthi kwaSingleCare bangakwazi ukusiza ukunciphisa izindleko zezidakamizwa.
