Lebitso la Latin: Hydrochlorothiazide

Khoutu ea ATX: C03AA03

Motsoako o sebetsang: Hydrochlorothiazide (Hydrochlorothiazide)

Analogs: Hypothiazide, Hydrochlorothiazide-SAR Hydrochlorothiazide-Verte, Dichlothiazide

Moetsi: Valenta Pharmaceuticals OJSC (Russia), Borshchagovsky HFZ (Ukraine), LEKFARM LLC, (Rephaboliking ea Belarus)

Tlhaloso e fetelletse ka nako ea: 03/10/17

Theko ea litlhare tsa marang-rang:

Hydrochlorothiazide ke diuretic e sebelisetsoang mafu a liphio, matšoafo, sebete le pelo ho fokotsa edema.

Matšoao a ho sebelisoa

khatello ea mali ea methapo (khatello e phahameng ea mali),
lefu la tsoekere (tlolo ea tekanyo ea letsoai la metsi 'meleng, le etsahalang ka lebaka la phokotseho ea secretion ea li-hormone tsa antidiuretic),
pelo e ferekaneng,
jade le nephrosis,
cirrhosis ea sebete
lejoe prophylaxis,
mathata a boimana: ho senyeha ha meno, edema, eclampsia (khatello e phahameng haholo ea mali),
edematous syndrome ea methapo e sa tšoaneng,
mefuta e tlatsitsoeng ea glaucoma.

Contraindication

hypersensitivity ho likarolo,
khaello ea lactose, galactosemia le monko o bobebe oa galactose le tsoekere.
ts'ebeliso e sa sebetseng ea renal le hepatic,
lefu la tsoekere le matla, gout, anuria (ho haella ha moroto ho ea senya),
hypercalcemia (calcium e phahameng ea mali),
systemic lupus erythematosus, pancreatitis.

Litlamorao

Ts'ebeliso ea hydrochlorothiazide e kanna ea baka litlamorao tse latelang:

ho hlatsa, ho nyekeloa ke pelo, ho ipolaisa tlala, molomo o omileng, dyspepsia (mathata a ho ja),
ts'ebetso ea ho senyeha ha sebete, jaundice, cholecystitis (ho ruruha gallbladder), pancreatitis (ho ruruha ha manyeme),
ho tsitsipana, pherekano, ho bola, ho fokotseha ho tsepamisa mohopolo, ho teneha, ho tepella,
ho otla ha pelo, ho tsitsinyeha ha morethetho oa pelo, thrombocytopenia, agranulocytosis,
urticaria, ho hlohlona ha letlalo, ho hlasimoloha hoa leseli (khanya e eketsehileng ho khanya),
ho fokotseha libido, potency e sa sebetseng, bohloko ba spastic, hypokalemia (maemo a tlase a potoloho ea ions maling).

Bongata

Haeba ho na le overdose ea hydrochlorothiazide, lipontšo tse joalo li ka hlaha:

ho nyekeloa ke pelo, bofokoli,
ho tsekela
tsitsipano e kholo moeling oa motlakase oa motlakase,
ho mpefala ha lefu la gout.

Ha ho na litlhare tse tobileng. Phekolo ea matšoao le taolo ea tekanyo ea li-electrolyte tsa 'mele li beiloe.

Tabeng ea hypokalemia, ho khothalletsoa tšebeliso ea potasiamo chloride kapa asparkam. Ka linako tse ling ho ka etsahala sebopeho sa hyperchloremic alkalosis (liphetoho tsa metabolism ea electrolyte). Ebe mokuli o laetsoe ho hlahisoa ha saline ea 0.9% (sodium chloride). Tabeng ea lipontšo tse bonolo tsa gout, allopurinol e sebelisoa.

Ha u nka tekanyetso e kholo, mokuli, ntle le ho hlaka, o tlameha ho ba setsing sa bongaka se tlas'a tlhokomelo ea litsebi.

Hypothiazide, Hydrochlorothiazide-ATS Hydrochlorothiazide-Verte, Dichlothiazide.

Ketso ea pharmacological

Matla a ho hlohlona ha hydrochlorothiazide a teng ho bokhoni ba eona ba ho pepesa potasiamo, bicarbonate le magnesium ion hammoho le moroto.

E fana ka phokotso ea reabsorption (reversorp) ea metsi, chlorine le ion ea sodium ho li-distal tubules. E sebetsa metsong ea distal, e fokotsa ho pepesetsoa ha ion ea calcium le ho thibela ho etsoa ha majoe a khalsiamo a liphio.
E eketsa bokhoni ba lits'oants'o tsa liphio, e thibela ts'ebetso ea methapo ea methapo ea mali ho fihlela ketso ea babuelli, e amehang phetisong ea litšusumetso tsa methapo. Matlapa a boetse a sebelisoa kalafong ea batho ba fumanang kalafo ka li-ejenti tsa lihormone (estrogens, corticosteroids).
E tšoauoa ka phello e matlafatsang, hape e fokotsa popeho ea morine o mongata ho batho ba nang le lefu la tsoekere. Ho feta moo, lithethefatsi maemong a mang li khona ho fokotsa khatello ea methapo.
Kamora ho tsamaisoa ka molomo, e kenella hantle ka mpeng mme e supe ke liphio hoo e batlang e sa fetohe.
Ts'ebetso e kholo e bonoa lihora tse 4 kamora tsamaiso mme e etsahala lihora tse 12 tse latelang. E khona ho feta ka har'a placenta le ka lebese la matsoele.

Litaelo tse khethehileng

Ka tlhokomeliso e fetelletseng, e ngoletsoe bakuli ba tsofetseng, bakuli ba nang le lefu la methapo ea methapo ea pelo le bokong hammoho le lefu la tsoekere.
Nakong ea kalafo, hoa hlokahala ho qoba ho pepesetsoa ke letsatsi nako e telele, kaha setlhare se baka kutloisiso e eketsehileng ea letlalo ho radiation ea ultraviolet.
Lithethefatsi li ka fanoa feela ka mor'a ho hlahloba ka hloko tekanyo ea melemo ea likotsi bakeng sa bakuli ba nang le metabolism ea mafura a sa foleng, litekanyetso tse eketsehileng tsa triglycerides le cholesterol maling a mali, hammoho le se nang le sodium e ngata 'meleng.

Ho sebelisana le lithethefatsi

Ka tšebeliso e ts'oanang ea ba phomotsang mesifa e sa nyenyefatse, li-antihypertensive, phello ea bona ea ntlafala.
Ha e kopantsoe le corticosteroids, ho na le kotsi ea hypokalemia le hypthension ea orthostatic.
Ka tšebeliso e tšoanang ea ethanol, diazepam, barbiturates, menyetla ea ho ba le hypotension ea orthostatic e eketseha.
Ka tsamaiso e rarahaneng e nang le li-inhibitors tsa ACE, phello ea antihypertensive e ea matlafatsoa.
Ka tsamaiso e tšoanang ea lithethefatsi tsa hypoglycemic ea molomo, ts'ebetso ea bona ea fokotseha.

Hydrochlorothiazide

Lebitso la Latin: Hydrochlorothiazide

Khoutu ea ATX: C03AA03

Motsoako o sebetsang: hydrochlorothiazide (Hydrochlorothiazide)

Mohlahisi: Atoll LLC (Russia), Pharmstandard-Leksredstva OJSC (Russia), Pranafarm LLC (Russia)

Tlhabollo ea litlhaloso le setšoantšo: 07/10/2019

Litheko makaleng a litlhare: ho tloha li-ruble tse 42.

Hydrochlorothiazide ke diuretic.

Sokolla foromo le sebopeho

Foromo ea litekanyetso - matlapa: potoloha, sephara-cylindrical, e nang le notch ka lehlakoreng le le leng le chamfers ka mahlakoreng ka bobeli, hoo e batlang e le bosoeu kapa bosoeu (likotoana tse 10 le 20 ka mekotleng ea blister, 10, 20, 30, 40, 50, 60 le Li-pcs tse 100 likoteng, likareng tsa likarete tse 1, 2, 3, 4, 5, 6, 10, kapa 1 litaelo le litaelo tsa tšebeliso ea hydrochlorothiazide).

Letlapa la 1

ntho e sebetsang: hydrochlorothiazide - 25 kapa 100 mg,
likarolo tse thusang: starch ea poone, cellulose ea microcrystalline, lactose monohydrate (tsoekere ea lebese), magnesium stearate, povidone-K25.

Mofumahali

Hydrochlorothiazide ke matla a mahareng a thiazide diuretic.

Setlhare se fokotsa ho khutlisetsoa ha sodium karolong ea cortical ea loop ea Henle, leha e sa ame karolo ea eona e fetang karolong ea bokong ba lesea. Sena se hlalosa phello e fokolang ea diuretic ea hydrochlorothiazide ho feta furosemide.

Hydrochlorothiazide e thibela anicrase ea carbonic ho li-tubules tsa proximal tse ntlafalitsoeng, e ntlafatsa tlhahiso ea liphio tsa hydrocarbons, phosphates le potasiamo (ka har'a distal tubules, sodium e fapanyetsoa potasiamo). E liehisa calcium ion 'meleng le excretion ea urate. E eketsa tlhahiso ea magnesium. Hoo e batlang e se na phello maemong a acid-base (sodium e kenyelletsoa hammoho le chlorine kapa ka bicarbonate, ka hona, ka acidosis, tlhahiso ea chloride e ntlafalitsoe, ka alkalosis - bicarbonates.

Phello ea diuretic ea hydrochlorothiazide e hlaha ka hare ho lihora tse 1-2 kamora ho sebelisa moriana, e fihla hofihlella kamora lihora tse 4 mme e nka lihora tse 6 - 6. Phello e fokotseha ka sekhahla sa ho fokotseha hoa mocheso oa glomerular, ka boleng ba eona ba 2 ea 'mele oa 1 ka letsatsi. Tekanyetso ea letsatsi le letsatsi ea bana ba lilemo tse 3-12 e ka tloha ho 37,5 ho isa ho 100 mg. Kamora matsatsi a 3-5 a kalafo, ho khothalletsoa ho nka phomolo bakeng sa palo e lekanang ea matsatsi. Ka kalafo ea tlhokomelo, moriana o nooa ka tekanyetso e khothalletsoang makhetlo a 2 ka beke. Ho bakuli ba fumanang phekolo ea nakoana le Hydrochlorothiazide hang ka mor'a matsatsi a 1-3 kapa ka tsamaiso bakeng sa matsatsi a 2-3 e lateloang ke khefu, karabelo e mpe e ba tlase hangata mme katleho ea kalafo ha e hlalosoe.

Litlamorao

Litla-morao tse hlalositsoeng ka tlase li thathamisitsoe ho latela khafetsa ea ntlafatso ka tsela e latelang: khafetsa - ho feta 1/10, hangata ho feta 1/100, empa ka tlase ho 1/10, hangata - ho feta 1/1000, empa e le tlase ho 1/100, ka seoelo - ho feta 1/11 10 000, empa e le ka tlase ho 1/1000, ka seoelo - ka tlase ho 1/10 000, ho kenyelletsa melaetsa e le 'ngoe:

ho ferekana ha tekano ea motlakase oa metsi: hangata - hypercalcemia, hypomagnesemia, hypokalemia, hyponatremia (e bonahatsoang ke makhopho a mesifa, mokhathala o eketsehileng, ho fokotseha ha mohopolo, ho teneha, ho teneha, pherekano, ho tepella maikutlo, ho tsitsipana), hypochloremic alkalosis (e bonahatsoang ke membrane ea mucous, , ho nyekeloa ke pelo, ho hlatsa, ho feto-fetoha ha maikutlo le kelello, ho nyekeloa, mesifa le bohloko ba mesifa, bofokoli kapa mokhathala o sa tloaelehang), o ka bakang hepatic e tsefalopatiyu kapa e amanang le sebete coma,
mathata a metabolic: khafetsa - glucosuria, hyperglycemia, hyperuricemia ka nts'etsopele ea tlhaselo ea gout, nts'etsopele ea mamello ea tsoekere, pontsho ea lefu la tsoekere la morao-rao, ka tšebeliso ea hydrochlorothiazide litekanyetso tse phahameng - keketseho ea lipids ho serum ea mali,
ho tsoa ho tsamaiso ea pelo le pelo: ka seoelo - orthostatic hypotension, bradycardia, vasculitis,
ho tsoa ho tsamaiso ea musculoskeletal: ka seoelo - mesifa ea mesifa,
Ho tsoa lithong tsa hemopoietic: hangata - hemolytic / anemia ea aplasia, agranulocytosis, leukopenia, thrombocytopenia,
ho tsoa ho ts'ilo ea lijo: ka seoelo - sialadenitis, lets'ollo, ho qhekella, ho nyekeloa le pelo, ho hlatsa, ho ipolaisa tlala, jaundice ea cholestatic, pancreatitis, cholecystitis,
ho tsoa ts'ebetsong ea methapo le litho tsa methapo ea kutlo: ka seoelo - pono e lerootho ea nakoana, tlhaselo e matla ea glaucoma e koalang, Myopia e hlobaetsang, ho tsekela hlooho, hlooho, ho akheha, paresthesia,
karabelo ea hypersensitivity: ka seoelo - photosensitivity, purpura, lekhopho la letlalo, ho hlohlona, urticaria, necrotizing vasculitis, Stevens-Johnson syndrome, karabelo ea anaphylactic ho fihlela ho ts'oaroa, lefu la khatello ea maikutlo (ho kenyeletsa pneumonitis le edema e se nang cardiogenic pulmonary edema),
ba bang: ho eketseha ha systemic lupus erythematosus, nephritis e ka hare, mosebetsi o sa sebetseng oa renal, o fokotsehile potency.

Theko ea litlhare tsa meriana

Litsenyehelo tsa hydrochlorothiazide bakeng sa sephutheloana se le seng li tsoa ho li-ruble tse 50.

Tlhaloso e leqepheng lena ke mokhoa o bonolo oa mofuta oa semolao sa semolao. Tlhahisoleseling e fanoe molemong oa tlhaiso-leseling feela mme ha se tataiso bakeng sa kalafo. Pele u sebelisa lithethefatsi, u lokela ho etela setsebi 'me u itloaetse litaelo tse lumellaneng le moetsi.

Tekanyetso le tsamaiso

Ho theola khatello ea mali: ka molomo, 25-50 mg / ka letsatsi, ha diuresis tse nyane le li-natriureis li bonoa feela ka letsatsi la pele la tsamaiso (e laetsoeng nako e telele ho kopantsoe le lithethefatsi tse ling tsa antihypertensive: vasodilators, angiotensin-converting enzyme inhibitors, sympatholytics, beta-blockers). Ka keketseho ea lethal dose ho tloha ho 25 ho isa ho 100 mg, keketseho e lekanang ea diureis, natriuresis le ho fokotseha ha khatello ea mali li bonoa. Ka tekanyetso e le 'ngoe ea limilimithara tse fetang 100, keketseho ea li-diuresis le ho fokotseha ho eketsehileng ha khatello ea mali ha li na thuso, tahlehelo e eketsehang ea li-electrolyte, haholo potasiamo le magnesium ion. Ho eketsa lethal dose ka makhetlo a 200 mg ha ho na thuso, hobane eketseha diuresis ha e etsahale.

Ka lefu la edematous (ho latela boemo le karabelo ea mokuli) e laetsoe ka tekanyetso ea letsatsi le letsatsi ea 25-100 mg, e nooa hang (hoseng) kapa litekanyetso tse 2 (hoseng) kapa nako e le ngoe ka matsatsi a 2.

Batho ba baholo - 12,5 mg 1 - makhetlo a 2 ka letsatsi.

Bakeng sa bana ha a le lilemo li 3 ho isa ho tse 14 - 1 mg / kg / letsatsi.

Kamora matsatsi a 3 ho isa ho a 5 a kalafo, ho kgothaletswa ho nka phomolo matsatsi a 3 ho isa ho a 5. Ha kalafo ea tlhokomelo e le tekanyetso e boletsoeng e beoa makhetlo a 2 ka beke. Ha o sebelisa phekolo ea nakoana ea kalafo le tsamaiso ka mor'a matsatsi a 1 ho isa ho a 3 kapa matsatsi a 2 ho isa ho a 3, ebe o lateloa ke khefu, ho fokotseha ha ts'ebetso ha ho boleloe haholo mme litla-morao li hlaha khafetsa.

Ho fokotsa khatello ea methapo 25 mg e beoa hang kamora matsatsi a 1 ho isa ho a tšeletseng, phello e etsahala kamora lihora tse 24 ho isa ho tse 48.

Ka lefu la tsoekere - 25 mg 1 - makhetlo a 2 ka letsatsi ka keketseho ea butle-butle ea lethal dose (letsatsi le letsatsi lethal dose - 100 mg) ho fihlela phello ea kalafo e ka fumaneha (ho fokotseha ha lenyora le polyuria), ho fokotsa tekanyo e eketsehileng hoa khoneha.

Likarolo tsa ts'ebeliso

Ka kalafo ea nako e telele, ho hlokahala hore ka hloko u hlahlobe matšoao a kliniki a ho leka-lekana ha metsi a motlakase, haholo ho bakuli ba kotsing e kholo: bakuli ba nang le mafu a methapo ea methapo ea pelo le ts'ebetso ea sebete e sa sebetseng.

Hypokalemia e ka qojoa ka ho sebelisa lithethefatsi tse nang le potasiamo kapa lijo tse nang le K + (potasiamo) (litholoana, meroho) haholo-holo maemong a tahlehelo e eketsehang ea K + (diuresis e matla, kalafo ea nako e telele) kapa kalafo e ts'oanang ka pelo le glycosides ea pelo kapa glucocorticosteroids.

E eketsa keketseho ea magnesium ka moriring, e ka lebisang ho hypomagnesemia.

Ho sa sebetseng hantle haholo ke lefu la renal (CRF), ho hlokahala hore ho hlahlojoe nako le nako ea ho ba le tumello ea creatinine. Ha a sa sebetse hantle hantle ke lefuba, sethethefatsi se ka ipokella, sa baka nts'etsopele ea azotemia. Ka nts'etsopele ea oliguria, monyetla oa ho tlohela lithethefatsi o lokela ho nahanoa.

Maemong a bonolo a ho fokotseha ha sebete le mafu a sebete a tsoelang pele, moriana o laetsoe ka hloko, kaha phetoho e nyane molekeng oa electrolyte ea metsi le ho bokellana ha ammonia serum ho ka baka lefu la hepatic.

Haeba ho na le bothata bo tebileng ba 'mele le bohloeki, ho sebelisa lithethefatsi ho hloka tlhokomelo e khethehileng.

E kanna ea sitisa mamello ea tsoekere. Nakong ea kalafo e telele ea phekolo ea lefu la tsoekere le hlahang le lefu la tsoekere, ho ka hlokahala hore ho etsoe tlhahlobo e hlophisehileng ea metabolism ea "carbohydrate metabolism"; Nakong ea kalafo, ho hlokahala hore ho hlahlojoe nako le nako ea uric acid e hlaphohetsoeng.

Ka kalafo ea nako e telele, maemong a sa tloaelehang, ho ile ha bonoa phetoho ea methapo ea tšebetso ea methapo ea kutlo e tsamaeang le hypercalcemia le hypophosphatemia. E kanna ea ama liphetho tsa liteko tsa laboratori tsa ts'ebetso ea parathyroid, ka hona, pele ho khetholla ts'ebetso ea litšoelesa tsa parathyroid, lithethefatsi li lokela ho khaotsa.

Hydrochlorothiazide e ka fokotsa palo ea iodine e hokahanang le liprotheine tsa serum ntle le ho bonts'a matšoao a ts'ebetso ea qoqotho ea "thyroid".

Karolong ea pele ea ts'ebeliso ea lithethefatsi (nako ea nako ena e behiloe ka bonngoe), ho khothalletsoa ho hana ho khanna le ho etsa mosebetsi o hlokang ho tsepamisa mohopolo le lebelo la karabelo ea psychomotor (ka lebaka la nts'etsopele ea ho tsekela le ho otsela), nakong e tlang, tlhokomeliso e lokela ho sebelisoa.

Pharmacological thepa ea lithethefatsi

Letlapa la Hydrochlorothiazide ke diaztiti tsa thiazide. Ntho e sebetsang ea lithethefatsi e sitisa ho kenngoa ha sodium, metsi le chlorine ion likarolong tse hole tsa renal tubules, hape e ntlafatsa tlhahiso ea potasiamo le ion ea magnesium.

Phekolo e phahameng ka ho fetisisa ea ho phekola e hlaha lihora tse 2 kamora ho nka pilisi kahare mme e nka lihora tse 12.

Ka lebaka la ho tlosoa ha mokelikeli o mongata ho tsoa 'meleng, ntho e sebetsang ea diuretic e thusa ho fokotsa khatello e phahameng ea mali, e fokotsa edema le ho fokotsa polyuria ho bakuli ba nang le lefu la tsoekere.

Tšebeliso ea moriana nakong ea kemolo le nakong ea kanyeso

Ts'ebeliso ea matlapa a hydrochlorothiazide ho trimester ea pele ea kemaro e thibetsoe ka tieo, hobane nakong ena ho etsoa ha litho tsa mpa le litsamaiso li etsahala, le meriana e ka sitisa ts'ebetso ena.

Ts'ebeliso ea lithethefatsi ho "trimesters" ea 2 le ea 3 ea bokhachane e ka etsahala feela kamora tlhahlobo e felletseng ea matšoao a melemo / kotsi le ka tlasa taolo e tiileng ea ngaka.

Tšebeliso ea lithethefatsi nakong ea letsoele e thibetsoe, hobane likarolo tsa ts'ebetso ea lithethefatsi li ka kenella ka lebeseng la matsoele, ebe li kena 'meleng oa ngoana ka lijo. Haeba kalafo e nang le hydrochlorothiazide e hlokahala, ho lactation ho lokela ho emisoa!

Litlamorao

Ka tšebeliso e nepahetseng ea lithethefatsi, litla-morao li hlaha maemong a sa tloaelehang haholo. Haeba ka boithatelo u feta tekanyetso e khothalletsoang kapa tšebeliso e sa laoloeng ea lithethefatsi, ho ka hlaha maemo a latelang ho bakuli:

Mathata a amanang le ho ja ka mpeng: ho ruruha ha manyeme, cholecystitis, mathata a ka setulong, ho hloka takatso ea lijo, jaundice, bohloko ka har'a sebete,
Ho sitisoa ha pono
Dizziness kapa hlooho,
Boikutlo ba "ho khasa" letlalong,
Ntshetsopele ea vasculitis, anemia, leukopenia, hyponatremia,
Phephetso khahlanong le semelo sa tlolo ea tekano ea letsoai la metsi 'meleng,
Pherekano kapa ho eketseha ha tšabo ea methapo
Lenyora le ntseng le eketseha, molomo o omeletseng,
Ho nyekeloa ke pelo le ho qhekella
Bofokoli bo ntseng bo hola kapa ho tepella,
Liphetoho tsa letlalo le ho kula - urticaria, angioedema, rashes,
Bohloko ba mesifa
Ho senyeha ha liphio le sebete, maemong a matla, kholo ea ho hloleha ha sebete ho fihlela ho akheha.

Ho sebelisana ha sethethefatsi le lithethefatsi tse ling

Ka tšebeliso e le 'ngoe ea litafole tsa hydrochlorothiazide tse nang le lithethefatsi tse seng khahlanong le' mele tse thibelang lefu la mokokotlo kapa li-anticoagulants tse sa tobang, phello ea kalafo ea diuretiki e ntlafalitsoe, e lokelang ho tsotelloa ha u fana ka litlhare.

Tšebeliso e tšoanang ea sethethefatsi sena ka li-antidepressants, barbiturates, kapa ethanol, ho na le keketseho ea phello ea eona ea hypotensive.

Ntho e sebetsang ea hydrochlorothiazide e fokotsa phello ea bokhachane ea lipilisi tsa thibelo ea bokhachane, e lokelang ho lemosoa ho bakuli ba khethang mofuta ona oa ts'ireletso khahlanong le boimana bo sa batleheng.

Litafole tsa Diuretic, haholo-holo hydrochlorothiazide, li eketsa kotsi ea litlamorao nakong ea kalafo e nang le pelo glycosides.

Maemo a ho ajoa le ho bolokoa ha moriana

Matlapa a Hydrochlorothiazide a tšeloa ka har'a meriana le ntle le taelo ea ngaka. Moriana o lokela ho bolokoa o le hole le bana ka mocheso o sa feteng 20 degrees. Bophelo ba matlapeng a matlapa ke lilemo tse 2 ho tloha mohla li hlahisoang.

Litsenyehelo tse tloaelehileng tsa Hydrochlorothiazide ea lithethefatsi ka mokhoa oa litafole tse fumanehang litlolong tsa meriana ea litlama ke li-ruble tse 60-70.