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The groupMochegonnami means, or dioretikami cite substance extending down from the body in urine and reduce the fluid in the tissues and serozhnykh body cavities. Dioretikami induced increase mocheotdelenia linked to their specific effects on the kidneys, consisting primarily in the power reabsorbtion of sodium ions in kidney Channel, which has been accompanied by a decrease in reabsorbtion water. The smaller role increased filtering in clubockah.
Modern mochegonne funds from the following groups :
a) dioretiki "petleve 'and acting korticalny segment Genle loop;
b) dioretiki kalisberegate;
Dioretiki have varying in intensity and duration influence mocheobrazovanie that depends on their physico-chemical properties, mechanism of action and its localization (various sites nefrona).
The most powerful of the existing dioretikov are "petleve". " The chemical structure they represent derivatives сульфамоилантранилов ой and �ихлорфеноксиуксусно�� acids (furosemide, bufenox, etakrinova acid, etc.). There petleve dioretiki throughout the bottom of the loop nefrona (Genle hinges), and sharply repressed reabsorbqiyu ion chlorine and sodium. increasing the availability of potassium ions.
The very effective lilac will include tiazida-derivatives benzotiadiazina (hydrochlorothiazide, ziklometiazid etc.). Their effect is mainly korticalnom segment hinges nefrona where blocked reabsorbece cations (sodium and potassium). Characterized them gipokaliemia, sometimes very dangerous.
As petleve dioretiki or benzotiadiazina used in the treatment of hypertension and chronic heart failure. Increasing diurez, they reduce the BCC, respectively, the venous return to the heart and pressure on miocard reduce stoppages in the lungs. Tiazida also directly rasslablaut wall receptacles : changing metabolic processes in the cell membranes arteriol, in particular reduced concentration of sodium ions, which leads to a reduction of swelling and reduced peripheral resistance vessels. Influenced tiazidov changing reactivity vascular system, declining pressorne reaction to the substance sossoudossoujiwate (adrenaline, etc.) and a growing depressornaya reaction to ganglioblokirute funds.
Kalisberegate dioretiki also increases the sodium ions, but at the same time reduce the potassium ion. They operate in the field of distal channel where exchange ions of sodium and potassium. The force and duration of effect are significantly below "looped", but do not pose a gipokaliemii.
Key members of this group-the spironolactone, triamteren, amiloride - differ in the action. Spironolactone - aldosterone antagonist, and its therapeutic activity to rise with the level and products in the body concentration. Triamteren and amiloride are aldosterone antagonists, under the influence of these drugs permeability of cell membranes covering distal channel selectively reduced for sodium ions; Last remains proswete kanalza and holds water, which leads to an increase in diureza.
Препараты группы осмодиуретиков - единственные, не ""блокируют"" мочеобразование. They filtruacy increase pressure KISR "primary urine" (clubochkovogo leachate) than from reabsorbtion water in the proximal bone. The most active osmotic dioretiki (mannit, etc.) apply to a High diurez in acute poisoning (barbituratami, salicilatami etc.), acute renal failure, as well as in acute heart failure in patients with reduced renal filtration. As degidratiruth funds are subject to oteke brain.