Diuretics: Isticmaalka, noocyada caanka ah, iyo macluumaadka badbaadada

Macluumaadka Daroogada

Liistada Diuretics | Waa maxay diuretic? | Sida ay u shaqeeyaan | Isticmaala | Noocyada | Ayaa qaadan kara daawada diureyga ah? | Amniga | Dhibaatooyinka ay keento | Kharashaadka

Diuretics-ka, oo badanaa loo yaqaan kaniiniyada biyaha, waxay kordhiyaan xaddiga dareeraha jirka looga saarayo kaadida. Mid ka mid ah kuwa ugu caansan ee loo yaqaan 'diuretics' dabiiciga ah waa kafeyn, inta badan laga helo kafeega iyo shaaha. Si kastaba ha noqotee, kafeynku wuxuu leeyahay saameyn khafiif ah oo si khaas ah looma isticmaalo sida durayaha goobaha caafimaadka.

Taariikhda casriga ah ee dadka diurey waxay bilaabeen 1919 markii arday caafimaad uu ogaaday in irbadaha ay ku jiraan meerkurigu ay waxtar u leeyihiin soo saarista biyaha bukaanka waraabowga. Ma ahayn ilaa 1950-meeyadii iyo 1960-yadii in daawooyinka loo yaqaan 'thiazides' iyo loop diuretics-ka loo yaqaan la helay oo si ballaaran loo isticmaalay. Maanta, durayaasha ayaa caadi ahaan loo qoraa si loo daaweeyo dhiig karka iyo xaaladaha kale.

Siiwad aqrinta si aad waxbadan uga ogaato noocyada kaladuwan ee diuretics, isticmaalkooda, iyo dhibaatooyinka soo raaca.

Liistada direega
Magaca Magaca (magaca guud)	Celceliska qiimaha lacagta	Qiimaha SingleCare	Wax dheeri ah baro
Microzide (hydrochlorothiazide)	$ 56 halkii 30, kaniiniyada 25 mg	Soo qaado rasiidh hydrochlorothiazide	Faahfaahinta Hydrochlorothiazide
Hygroton (chlorthalidone)	$ 31 halkii 30, kiniiniyada 25 mg	Soo qaado rasiidhada chlorthalidone	Faahfaahinta Chlorthalidone
Lozol (indapamide)	$ 46 halkii 30, kiniiniyada 2.5 mg	Soo qaado rasiidhada indapamide	Faahfaahinta Indapamide
Zaroxolyn (metolazone)	$ 105 halkii 30, kiniiniyada 2.5 mg	Soo qaado rasiidh metolazone ah	Faahfaahinta Metolazone
Bumex (bumetanide)	$ 91 halkii 30, kaniiniyada 1 mg	Soo qaado rasiidhada 'bumetanide'	Faahfaahinta Bumetanide
Lasix (furosemide)	$ 26 halkii 30, kaniiniyada 20 mg	Soo qaado rasiidh furosemide ah	Furosemide faahfaahinta
Demadex (torsemide)	$ 35 halkii 30, kaniiniyada 20 mg	Qaado tigidhada torsemide	Faahfaahinta Torsemide
Edecrin (ethacrynic acid)	$ 95 halkii 4, kaniiniyada 25 mg	Soo qaado rasiidhada ethacrynic acid	Faahfaahinta Ethacrynic acid
Midamor (amiloride)	$ 42 30kiiba, 5 mg kiniin ah	Soo qaado rasiidh amiloride ah	Faahfaahinta Amiloride
Dyrenium (triamterene)	$ 478 halkii 30, kaniiniyada 50 mg	Hel tigidhada triamterene	Faahfaahinta Triamterene
Aldactone (spironolactone)	$ 30 halkii 30, kaniiniyada 25 mg	Hel rasiidh spironolactone ah	Faahfaahinta Spironolactone
Inspra (eplerenone)	$ 235 halkii 30, kaniiniyada 25 mg	Soo qaado rasiidh eplerenone ah	Faahfaahinta Eplerenone

Daawooyinka kale ee diurey

• Diuril (chlorothiazide)
• Naturetin (bendroflumethiazide)
• Enduron (methyclothiazide)
• Renese (polythiazide)
• Saluron (hydroflumethiazide)
• Diamox (acetazolamide)
• Daranide (dichlorphenamide)
• Neptazane (methazolamide)
• Diurex (pamabrom)
• Osmitrol (mannitol)

Waa maxay diuretic?

Haddii kale waxaa loo yaqaan kaniiniyada biyaha, durayada waa daawooyin kordhiya qadarka milixda iyo biyaha ka baxa jirka. Daawooyinkani waxay kordhiyaan wax soo saarka kaadida ee laga soo saaro kelyaha, taas oo keenta socodka kaadida oo kordha, ama diuresis. Diuretics-ka ayaa caadi ahaan loo isticmaalaa in lagu daaweeyo dhiig kar (Dhiig-kar) iyo dheecaanka oo xajiya, ama barar, oo u soo ifbaxa calaamadda wadno-qabad la'aanta, dhibaatooyinka kelyaha, iyo beerka oo hawlgaba. Qaar ka mid ah daawada direega ah ayaa sidoo kale loo isticmaali karaa in lagu daaweeyo bararka maskaxda ee ay sababaan dhaawac madaxa ah oo daran ama barar indhaha ah oo ay keeneen xaaladaha indhaha sida glaucoma .

Sidee ayey durayaashu u shaqeeyaan?

Diuretics waxay ku shaqeysaa iyadoo la beddelayo dheelitirka biyaha, cusbada, iyo elektaroolka jirka.

Si gaar ah, waxay saameyn ku leeyihiin habsami u socodka kalyaha oo door ka ciyaara soodhiyamka iyo soo celinta korantada. Waxaa jira dhowr nooc oo kaladuwan oo ah diuretics. Mid kasta oo ka mid ahi wuu ka shaqeyn karaa qaybaha kala duwan ee kilyaha , xubinta shaandhada ee jirka. Kordhinta isku-darka soodhiyamka ee laga sii daayo kilyaha, biyo badan ayaa jirka looga soo bixiyaa kaadida.

Waxa laga yaabaa inay muhiim tahay in la fahmo qaab dhismeedka kilyaha iyo sida ay u shaqeyso in si buuxda loo fahmo sida daawada diureyku u shaqeyso. Kelida kasta waxaa ku jira in ka badan 1 milyan nephrons, kuwaas oo ah unugyada sifeynta ee soo saara qashinka isla markaana soo saara kaadi jirka. Waxay kuxirantahay nooca durayga, daawooyinkan waxay caadi ahaan ka shaqeeyaan isku-dhafka isku-dhafan ee isku-dhafan, addinka kore ee wareegga ee Henle, tubada isku-dhafan ee isku-dhafan, ama tuubada aruurinta.

Maxaa loo isticmaalaa daawada lagu durayo?

Diuretics waxaa loo isticmaali karaa in lagu daaweeyo xaalado kala duwan oo kala duwan oo saameeya wadnaha, kilyaha, iyo beerka. Waxaa sidoo kale loo isticmaalaa inay yihiin antihypertensives si loo yareeyo cadaadiska dhiigga. Diuretics-ka ayaa mararka qaarkood ay ku xadgudbaan kuwa qaba cilladaha cunnada si ay u lumiyaan miisaanka. Diuretics waxaa lagu heli karaa oo keliya warqad dhakhtar oo waxaa loo isticmaali karaa in lagu daaweeyo waxyaabaha soo socda:

• Wadne istaag
• Bidix Ventricular failure
• Dhiig kar
• Kalyaha oo xumaada
• Hawlgabka kelyaha ee Oliguric
• Dhagaxaanta kilyaha
• Dhaawac daran oo kilyaha ah
• Cudurka kilyaha
• Cudurka beerka
• Barar sanbabka
• Heerarka sare ee kaalshiyamka dhiigga (hypercalcemia)
• Heerarka sare ee dhiigga potassium (hyperkalemia)
• Cudurka kaadiheysta ee loo yaqaan 'Nephrogenic diabetes insipidus'
• Cadaadis saa'id ah oo gudaha ah
• Gulukooma

Noocyada durayo

Daawooyinka loo yaqaan 'Thiazide diuretics'

Thiazides waxay bartilmaameedsataa sootada-chloride cotransporter si ay u joojiso dib u soo celinta sodium, taas oo ka caawisa nidaaminta sodium iyo heerarka cadaadiska dhiigga. Qeyb ka mid ah daroogada, daawada thiazide ee diuretics-ka ayaa xannibaya dib-u-soo-celinta ugu yaraan 5% ee sodium ka sameysan tuubka isku dhafan. Thiazides sidoo kale waxay xannibtaa dib u soo celinta macdanta potassium, taasoo u horseedi karta jirka in laga takhaluso siyaado badan. Heerarka potassium ee hooseeya (hypokalemia) waxay u horseedi kartaa wadna garaac aan caadi ahayn, iyo dhibaatooyin kale. Saameyntooda darteed, thiazides waxaa badanaa loo isticmaalaa sidii daaweynta ugu horeysa ee dhiig karka halkii laga joojin lahaa ACE inhibitors. Tusaalooyinka thiazides waxaa ka mid ah Microzide (hydrochlorothiazide) iyo Hygroton (chlorthalidone).

Loop diuretics

Sida thiazides, diuretics loop ayaa sidoo kale gacan ka geysanaya hagaajinta heerarka sodium ee kilyaha. Si kastaba ha noqotee, loop diuretics waxay ka shaqeysaa addinka kor u kaca ee wareegga loo yaqaan 'Henle' ee loo yaqaan 'Henle' ee nephron. Daawooyinkani waxay bartilmaameedsadaan sootada-sodium-chloride cotransporter si loo joojiyo soodhiyamka iyo dib u soo celinta biyaha. Loop diuretics sidoo kale waxay yareyn kartaa nuugista potassium, taasoo u horseedi karta heerarka potassium ee jirka ku yar. Loop diuretics-ka ayaa loo isticmaali karaa in lagu daaweeyo wadnaha oo istaaga, kalyaha oo hawlgaba, heerarka kaalshiyamka oo sareeya (hyperkalemia), heerarka kaalshiyamka oo sareeya (hypercalcemia), iyo noocyada badan ee barar, sida barar sambabka. Tusaalooyinka looureynta loop-ka waxaa ka mid ah Bumex (bumetanide) iyo Lasix (furosemide) , iyo sidoo kale Demadex (torsemide).

Kaadi-kaydiyayaal dilaa ah

Kaadi-kaydiyayaal-ku-kaydinta-koolloolis ah ma keenaan dheecaan ka-baxa ah oo ay ku sii kordhaan kaadida. Kaadi-ku-daaweeynta dawada loo yaqaan 'potassium-sparing duray' sida amiloride waxay ku xidhan tahay kanaallada sodium si loo yareeyo dib-u-soo-celinta sodium ee dhiigga. Tani waxay kordhisaa dareeraha luminta iyada oo aan hoos u dhigin heerarka potassium. Daawooyinka kale ee kaashka leh ee kaashka ah sida spironolactone waxay ka shaqeeyaan tuubada durugsan iyo soo uruurinta marinnada si loo xakameeyo saameynta aldosterone, hormoon steroid ah oo kordhiya soo-celinta sodium. Tusaalooyinka diureykis-ka-ilaaliyaha jirka waxaa ka mid ah Midamor (amiloride), Dyrenium (triamterene), Aldactone (spironolactone), iyo Inspra (eplerenone).

Ka hortagayaasha kaarboon-anhydrase

Carbonic anhydrase waa enzyme laga helo qaybaha kala duwan ee jirka, oo ay ku jiraan unugyada dhiigga cas iyo isku-darka isku-darka kilyaha. Enzyme-kan wuxuu jirka ka caawiyaa inuu dib u soo celiyo sodium, bicarbonate, iyo chloride. Ka hortagayaasha kaarbooniga ah ee 'anhydrase inhibitors' ayaa xannibaya enzyme-kan si ay uga soo saaraan walxahaan iyo biyaha xad-dhaafka ah jirka. Kahortagayaasha 'Carbonic anhydrase inhibitors' ayaa badanaa loo isticmaalaa in lagu daaweeyo glaucoma. Tusaalooyinka waxaa ka mid ah Diamox (acetazolamide) iyo Neptazane (methazolamide).

Daawooyinka kale ee diurey

Daawada loo yaqaan 'Xanthine diuretics' waa nooc ka mid ah dareeraha khafiifa ee khafiifka ah ee xannibaya dib-u-soo-celinta dheecaanka ku jira tuubbada u dhow kilyaha. Tusaalooyinka dawada cunnada ee 'xanthine' waxaa ka mid ah kafeyn iyo Diurex (pamabrom). Daawada Osmotic U isticmaal habka osmosis-ka si aad uga soo saarto dheecaanka una yaraato haynta dareeraha. Daawooyinka Osmotic-ka ayaa ugu horreyn ka shaqeeya tuubbada u dhow iyo wareegga Henle. Daawada badanaa la isticmaalo ee loo yaqaan 'osmotic duray' waa Osmitrol (mannitol), taas oo loo isticmaalo in lagu yareeyo cadaadiska intracranial lana daaweeyo kelyaha oo xumaada.

Ayaa qaadan kara daawada diureyga ah?

Dadka waaweyn

Diuretics-ka ayaa badanaa loo isticmaalaa in lagu daaweeyo bararka iyo xaaladaha kale ee wadnaha iyo xididdada ee dadka waaweyn. Isticmaalka dawada dura ee dadka waaweyn waxay ku xirnaan doontaa xaalada la daweeyey.

Carruurta

Carruurta waxaa loo qori karaa daawada lagu durayo si loo yareeyo dheecaan badan waxaa sababa wadnaha oo isku dhegta ah iyo kelyaha oo shaqeynaya. Isticmaalka daawada diurey ee carruurta waxay ku xirnaan doontaa xaaladda la daweeyey. Qiyaasta daawada lagu durayo carruurta waxaa badanaa lagu xisaabiyaa miisaanka jirka.

Diuretics-ku ma aamin baa?

Diuretiyada guud ahaan waa daawooyin aamin ah markii loo isticmaalo sida loogu qoray. Saamaynta ay ku leeyihiin biyaha, cusbada, iyo dib u soo celinta elektaroolka, waxay sababi karaan isku dheelitirnaan la'aanta dareeraha iyo korantada. Hoos u dhaca dareeraha ee xad dhaafka ah ayaa sidoo kale u horseedi kara fuuqbax bukaanjiifka qaar. Heerarka potassium ee hooseeya ayaa sidoo kale laga yaabaa inay walaac ka muujiyaan waxyaalo badan oo diure ah marka laga reebo kuwa dilaalooba oo kaabis ka sameysmaya.

Isticmaalka isku-darka ee dawada direed iyo digoxin ama lithium ayaa u baahan kara in lala socdo ama laga fogaado. Kala hadal bixiye daryeel caafimaad wixii ku saabsan isdhexgalka daroogada ee kale ee suurogal ah ee diuretics.

Diuretics ayaa dib u xusuusanaya

Ma jiraan wax xusuus-qor ah oo hadda jira oo la xasuusto laga bilaabo Maarso 2021.

Xaddidaadda durayada

Ha u isticmaalin durayo haddii aad xasaasiyad ku leedahay waxyaabaha ku jira durayaasha. Daawooyinka qaarkood ee lagu durayo waxay ka kooban yihiin sulfa, taas oo u sababi karta falcelin xasaasiyadeed dadka la kulmay xasaasiyad xasaasiyadeed oo ku saabsan daawooyinka sulfonamide sida sulfamethoxazole.

Qaar ka mid ah dadka waayeelka ah ayaa laga yaabaa inay u baahdaan in lala socdo inta ay qaadanayaan daawada diureysa. Diuretics waxay kordhin kartaa halista dawakhaad ama ay ku dhacdaa dadka waayeelka ah hypotension postural-ka , ama hoos u dhac degdeg ah oo ku yimaada cadaadiska dhiigga markii la beddelayo fadhiyada iyo istaagga jagooyinka.

Ma qaadan kartaa daawada lagu durayo inta aad uurka leedahay ama naas nuujinta?

Diuretics-ka ayaa mararka qaarkood loo qoraa inta lagu jiro uurka dhiig karka ama xaaladaha wadnaha. Si kastaba ha noqotee, ammaankooda lama xaqiijin daraasado. Diuretics-ka waa in la isticmaalaa oo keliya haddii faa'iidooyinka ay ka badan yihiin halista. Qiyaaso badan oo ah daawada lagu durayo ayaa laga yaabaa inay saameyn ku yeelato soosaarida caanaha ayna xakameyso nuujinta haweenka naas nuujinaya. La tasho bixiye daryeel caafimaad wixii talo caafimaad ah kahor intaadan isticmaalin daawada lagu durayo inta aad uurka leedahay ama naas nuujinta.

Ma yihiin kuwa maaddooyinka la isku diro oo la xakameeyo?

Maya, durayaa maaddooyinka la kontoroolo.

Waxyeelada dawada ee dawada guud

Dhibaatooyinka ugu badan ee daawada diuretics ka mid ah:

• Kaadida oo soo noqnoqota
• Dawakhaad
• Madax-fudeyd
• Daal ama daal
• Madax xanuun
• Firiiric
• Muruqyo xanuun
• Shuban
• Cilad kacsi
• Heerarka sonkorta dhiigga oo kordhay

Dhibaatooyinka halista ah ee ay keento dadka diirka keena waxaa ka mid ah heerarka potassium ee hooseeya, ama hypokalemia, oo u horseedi kara wadna garaac aan caadi ahayn. Daaweyn la'aan, heerarka potassium ee hooseeya waxay u horseedi karaan dhibaatooyin nafta halis geliya. Kaadi-ku-daaweeynta jirka ee u kuur-ku-jirka ah ayaa u badan inaysan keenin saameyntan laakiin waxaa laga yaabaa inay taasi beddelkeeda keento heerarka sare ee potassium (hyperkalemia). Diuretics waxay sababi kartaa isku dheelitirnaan la’aanta kale ee elektroolka sida heerarka soodhiyamka oo hooseeya (hyponatremia) iyo heerarka kaalshiyamka oo hooseeya (hypocalcemia).

Diuretics sidoo kale way sababi kartaa fuuqbax sababta oo ah dheecaanka dheecaanno badan. Calaamadaha fuuqbaxa waxaa ka mid noqon kara harraad daran, jahwareer, iyo kaadi midab madow ah.

Qaar ka mid ah daawada sifeeyaha sida thiazides ayaa si ku meelgaar ah u kordhin kara heerarka kolestaroolka.

U sheeg dhakhtarkaaga haddii aad taariikh u leedahay mid ka mid ah xaaladaha soo socda ka hor intaadan isticmaalin dawada dura:

• Sonkorowga
• Turqo
• Dhibaatooyinka kilyaha
• Fuuqbax
• Qanjirada
• Lupus
• Dhibaatooyinka caadada

La hadal bixiye daryeel caafimaad si aad wax uga ogaatid waxyeelooyinka kale ee suurtagalka ah, digniinta, iyo taxaddarrada la xiriira daawada diuretics.

Immisa ayey ku kacayaan daawada direeygu?

Diuretics-ka guud ahaan waa daawooyin raqiis ah oo la awoodi karo kuwaas oo lagu heli karo nooc magac iyo noocyo caan ah. Ku dhowaad dhammaan qorshooyinka Medicare iyo caymiska ayaa dabooli doona waxyaabaha diurey-ga ah. Kharashyadu way kala duwanaan karaan iyadoo kuxiran qorshahaaga caymiska. Caymis la'aan, qiimaha diuretic way kala duwanaan kartaa iyadoo kuxiran tirada kiniiniyada loo qoro. Si kastaba ha noqotee, adoo adeegsanaya a kaarka lacag dhimista laga soo qaado SingleCare ayaa laga yaabaa inay kaa caawiso yareynta qiimaha daawada lagu durayo.