Диуретическое. Блокирует реабсорбцию ионов натрия и хлора в... Инструкция
Показания к применению
Отечный синдром различного генеза: Сердечный. Печеночный. Почечный после второго месяца беременности. Интоксикационный. Отек легких и мозга. Артериальная гипертензия . Форсированный диурез. Почечная недостаточность.
Противопоказания
Гиперчувствительность (в т.ч. к др. сульфон- и сульфаниламидам). Острый гломерулонефрит. Почечная недостаточность с анурией. Печеночная кома. Нарушение водно-солевого баланса и КЩС (гипокалиемия, гипонатриемия).C осторожностью применяют при: Гиперплазии предстательной железы. СКВ. Гипопротеинемии (риск развития ототоксичности). Сахарном диабете (снижение ...
В 1 мл раствора для инъекций содержится: Действующее веществоФуросемид 10,0 мг. Вспомогательные веществаНатрия хлорид, натрия гидроксил, вода для инъекций. В ампуле 2 мл раствора. В коробке 10 ампул.
Фармакологические свойства
Диуретическое. Блокирует реабсорбцию ионов натрия и хлора в восходящем колене петли Генле. Увеличивает также экскрецию калия , кальция , магния . C max возрастает с увеличением дозы, но время достижения максимума не зависит от дозы и варьирует в широких пределах в зависимости от состояния пациента. T 1/2 - около 2 ч. В плазме 91-99% связывается с белком, 2,4-4,1% находится в свободном состоянии. Биотрансформируется, в основном, в глюкуронид. Выводится с мочой (после в/в введения больше, чем при приеме внутрь). При в/в введении начало действия - через 5 мин, максимум - через 30 мин, длительность - около 2 ч. При в/в введении вызывает расширение вен, быстро снижает преднагрузку, уменьшает давление в левом желудочке и системе легочной артерии, снижает системное давление.
Показания к применению
Отечный синдром различного генеза: Сердечный. Печеночный. Почечный после второго месяца беременности. Интоксикационный. Отек легких и мозга. Артериальная гипертензия . Форсированный диурез. Почечная недостаточность.
Противопоказания
Гиперчувствительность (в т.ч. к др. сульфон- и сульфаниламидам). Острый гломерулонефрит. Почечная недостаточность с анурией. Печеночная кома. Нарушение водно-солевого баланса и КЩС (гипокалиемия, гипонатриемия).C осторожностью применяют при: Гиперплазии предстательной железы. СКВ. Гипопротеинемии (риск развития ототоксичности). Сахарном диабете (снижение толерантности к глюкозе ). При стенозирующем атеросклерозе церебральных артерий. На фоне продолжительной терапии сердечными гликозидами. У пациентов пожилого возраста с выраженным атеросклерозом. Беременность (особенно первая половина). Период лактации.
Применение при беременности и в период грудного вскармливания
При беременности следует использовать по строгим показаниям и только в течение короткого времени. На время лечения грудное вскармливание необходимо приостановить.
Способ применения и дозы
Устанавливают индивидуально, в зависимости от показаний, клинической ситуации, возраста пациента. В процессе лечения режим дозирования корректируют в зависимости от величины диуретического ответа и динамики состояния пациента. При в/в (струйном) или в/м введении доза для взрослых составляет 20-40 мг 1 раз/сут, в отдельных случаях - 2 раза/сут. Для детей начальная суточная доза для парентерального применения - 1 мг/кг.
Побочное действие
Со стороны сердечно-сосудистой системыСнижение АД, Ортостатическая гипотензия , коллапс, тахикардия , аритмии , снижение ОЦК. Со стороны ЦНС и периферической нервной системыГоловокружение , головная боль, Миастения , судороги икроножных мышц (тетания), Парестезии , апатия, адинамия, слабость, вялость, сонливость, спутанность сознания. Со стороны органов чувствНарушения зрения и слуха. Со стороны пищеварительной системыСнижение аппетита, сухость во рту, жажда, тошнота, рвота , запоры или диарея, холестатическая желтуха , панкреатит (обострение). Со стороны мочеполовой системыОлигурия, острая задержка мочи (у больных с гипертрофией предстательной железы), интерстициальный нефрит, гематурия, снижение потенции. Со стороны системы кроветворенияЛейкопения, тромбоцитопения, агранулоцитоз, апластическая анемия. Со стороны водно-электролитного обменаГиповолемия, дегидратация (риск развития тромбоза и тромбоэмболии), гипокалиемия, гипонатриемия, гипохлоремия, гипокальциемия, гипомагниемия, метаболический алкалоз. Со стороны обмена веществГиповолемия, гипокалиемия, гипонатриемия, гипохлоремия, гипокалиемический метаболический алкалоз (как следствие этих нарушений - артериальная гипотензия, Головокружение , сухость во рту, жажда, аритмия , мышечная слабость, судороги), гиперурикемия (с возможным обострением подагры), гипергликемия. Аллергические реакцииПурпура, крапивница, эксфолиативный дерматит, многоформная экссудативная эритема, васкулит, некротизирующий ангиит, кожный зуд, озноб, лихорадка, фотосенсибилизация, анафилактический шок. ПрочиеПри в/в введении (дополнительно) - тромбофлебит, кальциноз почек у недоношенных детей.
Передозировка
Симптомы: включают в себя артериальную гипотензию (вплоть до развития шока), острую почечную недостаточность, тромбоз, общую слабость и апатию. Лечение: специфического антидота не существует. Лечение симптоматическое, в основном направленное на коррекцию нарушений электролитного обмена.
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