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Арсенал терапевта: торасемид
Кириченко А.А. Арсенал терапевта: торасемид. Consilium Medicum. 2016; 18 (10): 55–60. DOI: 10.26442/2075-1753_2016.10.55-60
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Kirichenko A.A. The arsenal of therapist: torasemide. Consilium Medicum. 2016; 18 (10): 55–60. DOI: 10.26442/2075-1753_2016.10.55-60
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Аннотация
Приведено сопоставление фармакологических свойств, клинической эффективности фуросемида и торасемида у пациентов с артериальной гипертензией, хронической сердечной недостаточностью (ХСН), хронической почечной недостаточностью и при асците у больных циррозом печени. Торасемид сходен с фуросемидом по механизму диуретического действия, но имеет более высокую биодоступность (>80%) и более длительный период полувыведения (3–4 ч). При использовании в дозах 2,5–5 мг/сут торасемид снижает диастолическое артериальное давление до уровня менее 90 мм рт. ст. у 70–80% пациентов. Антигипертензивная эффективность торасемида сходна с таковой тиазидных и тиазидоподобных диуретиков. У больных с ХСН торасемид в дозе от 5 до 20 мг/сут является эффективным диуретиком. Биодоступность торасемида при приеме внутрь у пациентов с ХСН снижается лишь незначительно, диуретическое действие плавное, торасемид реже вызывает феномен «рикошета», его калийуретическое действие менее выражено. Общая и сердечно-сосудистая смертность в группе больных, принимавших торасемид, оказалась ниже (2,2% против 4,5% в группе сравнения); p<0,05. Фармакокинетические параметры торасемида не меняются при III (скорость клубочковой фильтрации – СКФ 30–59 мл/мин) и IV (СКФ 15–29 мл/мин) стадиях хронической болезни почек. У пациентов с хронической почечной недостаточностью терапия торасемидом и фуросемидом сопровождается сопоставимым возрастанием натрийуреза и снижением артериального давления.
Ключевые слова: артериальная гипертензия, хроническая сердечная недостаточность, хроническая почечная недостаточность, асцит, торасемид.
Ключевые слова: артериальная гипертензия, хроническая сердечная недостаточность, хроническая почечная недостаточность, асцит, торасемид.
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We performed the comparison of the pharmacological characteristics and clinical efficacy between furosemide and torasemide in patients with arterial hypertension, chronic heart failure (CHF), chronic kidney disease and in patients with ascites and cirrhosis. Antidiuretic mechanism of action of torasemide is similar to that of furosemide, but torasemide has a higher bioavailability (>80%) and a longer half-life (3–4 h). The administration of torasemide once a day at doses of 2.5–5 mg reduces diastolic blood pressure to a target BP of less than 90 mm Hg in 70–80% of patients. Antihypertensive efficacy of torasemide is similar to that of thiazides and thiazide-like diuretics. The administration of torasemide once a day at doses of 5 to 20 mg gives the effective diuretic action in patients with CHF. In CHF patients the bioavailability of torasemide is slightly reduced, diuretic action is smooth. Torasemide causes less potassium loss and rebound effect. Total and cardiovascular mortality in patients receiving torasemide is lower (2.2% vs 4.5% of the comparison group); p<0.05. Torasemide pharmacokinetic parameters are not changed in stages III (glomerular filtration rate – GFR 30 – 59 ml/min) and IV (GFR 15–29 ml/min) chronic kidney disease. Torasemide and furosemide therapy is accompanied by a comparable increase of natriuresis and lowering blood pressure in patients with chronic kidney disease.
Key words: arterial hypertension, chronic heart failure, chronic kidney disease, ascites, torasemide.
Key words: arterial hypertension, chronic heart failure, chronic kidney disease, ascites, torasemide.
Полный текст
Список литературы
1. Горбунов В.М., Оганов Р.Г. Торасемид – петлевой диуретик с особыми свойствами. Кардиоваск. терапия и профилактика. 2006; 5 (5). / Gorbunov V.M., Oganov R.G. Torasemid – petlevoi diuretik s osobymi svoistvami. Kardiovask. terapiia i profilaktika. 2006; 5 (5). [in Russian]
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3. Dunn CJ, Fitton A, Brogden RN. Torasemide. Review of its pharmacology and therapeutic use. Drugs 1995; 49: 121–42.
4. Brater DC. Torasemide. In: F.Messerli (ed.). Cardiovascular drug therapy. 2nd edition. Philadelphia, 1996; p. 402–12.
5. Achhammer I, Metz P. Low dose loop diuretics in essential hypertension: Experience with torasemide. Drugs 1991; 41 (Suppl. 3): 80–91.
6. Porcellati C, Verdecchia P, Schillaci G et al. La torasemide, nuovo diuretico del’ansa, nell trattamento dell’ipertensione ar-teriosa: Studio con trolla to in doppla cecita. Bas Razion Terapia 1990; 20: 407–10.
7. Baumgart P, Walger P, Von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. In: Progress in pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 169–81.
8. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190–3.
9. Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in elderly patients; randomized and double-blind study. In: Progress in Pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 183–209.
10. Boelke T, Piesche L. Influence of 2,5–5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. In: Diuretics IV: Chemistry, Pharmacology and clinical Applications. Excerpta Medica: Amsterdam, 1993; p. 279–82.
11. Achhammer I, Eberhard R. Comparison of serum potassium levels during long-term treatment of hypertension patients with 2.5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothiazide o.d. In: Progress in Pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 211–20.
12. Boelke T, Achhammer I, Meyer-Sabellek WA. Blutdrucksenkung und metabolische Veranderungen bei essentiellen Hypertonikem nach Langzeitgabe unterschiedlicher Diuretika. Hochdruck 1990; 9: 40–1.
13. Fortuno A, Muniz P, Ravassa S et al. Torasemide inhibits angiotensin II-induced vasoconstriction and intracellular calcium increase in the aorta of spontaneously hypertensive rats. Hypertension 1999; 34: 138–43.
14. Bоеlke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of today 1994; 8: 1–28.
15. Метелица В.И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. 3-е изд. М., 2005. / Metelitsa V.I. Spravochnik po klinicheskoi farmakologii serdechno-sosudistykh lekarstvennykh sredstv. 3-e izd. M., 2005. [in Russian]
16. Patterson J, Adams K, Applefeld M et al. Oral torasemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Torasemide Investigators Group. Pharmacotherapy 1994; 14 (5): 514–21.
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18. Muller K, Gamba G, Jaquet F, Hess B. Torasemide vs. furosemide in primary care patients with chronic heart failure NYHA II to IV – efficacy and quality of life. Eur J Heart Fail 2003; 5 (6): 793–801.
19. Murray M, Deer M, Ferguson J et al. Open-label randomized trial of torasemide compared with furosemide therapy for patients with heart failure. Am J Med 2001; 111 (7): 513–20.
20. Spannheimer A, Muller K, Falkenstein P et al. Long-term diuretic treatment in heart failure: are there differences between furosemide and torasemide? Schweiz Rundsch Med Prax 2002; 91 (37): 1467–75.
21. Мареев В.Ю., Выгодин В.А., Беленков Ю.Н. Диуретическая терапия Эффективными дозами пероральных диуретиков торасемида (диувер) и фуросемида в лечении больных с обострением Хронической Сердечной Недостаточности (ДУЭЛЬ-ХСН). Сердечная недостаточность. 2011; 1: 3–10. / Mareev V.Iu., Vygodin V.A., Belenkov Iu.N. Diureticheskaia terapiia Effektivnymi dozami peroral'nykh diuretikov torasemida (diuver) i furosemida v lechenii bol'nykh s obostreniem Khronicheskoi Serdechnoi Nedostatochnosti (DUEL''-KhSN). Serdechnaia nedostatochnost'. 2011; 1: 3–10. [in Russian]
22. Агеев Ф.Т., Жубрина Е.С., Середенина Е.М. и др. Сравнительная эффективность и безопасность длительного применения торасемида и фуросемида у больных с компенсированной сердечной недостаточностью. Влияние на маркеры фиброза миокарда. Сердечная недостаточность. 2013; 14 (2). / Ageev F.T., Zhubrina E.S., Seredenina E.M. i dr. Sravnitel'naia effektivnost' i bezopasnost' dlitel'nogo primeneniia torasemida i furosemida u bol'nykh s kompensirovannoi serdechnoi nedostatochnost'iu. Vliianie na markery fibroza miokarda. Serdechnaia nedostatochnost'. 2013; 14 (2). [in Russian]
23. Vargo DL, Kramer WG, Black PK et al. Bioavailiability, pharmacokinetics and pharmacodynamics of torasemide and furosemide in patients with congestive heart failure. Clin Pharmacol Ther 1995; 57 (6): 601–9.
24. Guidelines for the diagnosis and treatment of Chronic Heart Failure: full text (update 2005). The Task Force for the diagnosis and treatment of CHF of the European Society of Cardiology.
25. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of chronic heart Failure in the Adult.
26. Risler T, Kramer B, Muller G. The efficacy of diuretics in acute and chronic renal failure. Focus on torasemide. Drugs 1991; 41 (Suppl. 3): 69–79.
27. Kult J, Hacker J, Glocke M. Comparison of efficacy and tolerance of different oral doses of torasemide and furosemide in patients with advanced chronic renal failure. Arznt-Forsch/Drug Res 1998; 38: 212–4.
28. Vasavada N, Saha C, Agarwal R. A double-blind randomized crossover trial of two loop diuretics in chronic kidney disease. Kidney Int 2003; 64 (2): 632–40.
29. Gerbes A, Bertheau-Reitha U, Falkner C et al. Advantages of the new loop diuretic torasemide over furosemide in patients with cirrhosis and ascites. A randomized, double blind cross-over trial. J Hepatol 1993; 17 (3): 353–8.
30. Fiaccadori F, Pedretti G, Pasetti G et al. Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study. Clin Invest 1993; 71 (7): 579–84.
31. Фомин В.В. Свойства антагониста альдостерона у петлевого диуретика: случайность или необходимость? Справ. поликлин. врача. 2010; 4. / Fomin V.V. Svoistva antagonista al'dosterona u petlevogo diuretika: sluchainost' ili neobkhodimost'? Sprav. poliklin. vracha 2010; 4. [in Russian]
32. Моисеев С.В. Клиническая эффективность и безопасность применения петлевого диуретика торасемида. Кардиология. 2006; 4. / Moiseev S.V. Klinicheskaia effektivnost' i bezopasnost' primeneniia petlevogo diuretika torasemida. Kardiologiia. 2006; 4. [in Russian]
33. Gerbes A, Bertheau-Reitha U, Falkner C et al. Advantages of the new loop diuretic torasemide over furosemide in patients with cirrhosis and ascites. A randomized, double blind cross-over trial. J Hepatol 1993; 17 (3): 353–8.
34. Fiaccadori F, Pedretti G, Pasetti G et al. Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study. Clin Invest 1993; 71 (7): 579–84.
35. MDS pharma services Clinical study report. Comparative, randomized, single-dose, 2-way crossover bioavailability study of Polpharma S.A. and Roche (Torem) 10 mg Torasemide tablets in healthy adult volunteers under fasting conditions. Protocol N. AA15312. MDS pharma services project NO. AA15312.
2. Евдокимова А.Г., Коваленко Е.В., Ложкина М.В. и др. Особенности диуретической терапии при хронической сердечной недостаточности. Consilium Medicum. 2016; 18 (1). / Evdokimova A.G., Kovalenko E.V., Lozhkina M.V. et al. Characteristics of diuretic therapy in chronic heart failure. Consilium Medicum. 2016; 18 (1).
3. Dunn CJ, Fitton A, Brogden RN. Torasemide. Review of its pharmacology and therapeutic use. Drugs 1995; 49: 121–42.
4. Brater DC. Torasemide. In: F.Messerli (ed.). Cardiovascular drug therapy. 2nd edition. Philadelphia, 1996; p. 402–12.
5. Achhammer I, Metz P. Low dose loop diuretics in essential hypertension: Experience with torasemide. Drugs 1991; 41 (Suppl. 3): 80–91.
6. Porcellati C, Verdecchia P, Schillaci G et al. La torasemide, nuovo diuretico del’ansa, nell trattamento dell’ipertensione ar-teriosa: Studio con trolla to in doppla cecita. Bas Razion Terapia 1990; 20: 407–10.
7. Baumgart P, Walger P, Von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. In: Progress in pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 169–81.
8. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190–3.
9. Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in elderly patients; randomized and double-blind study. In: Progress in Pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 183–209.
10. Boelke T, Piesche L. Influence of 2,5–5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. In: Diuretics IV: Chemistry, Pharmacology and clinical Applications. Excerpta Medica: Amsterdam, 1993; p. 279–82.
11. Achhammer I, Eberhard R. Comparison of serum potassium levels during long-term treatment of hypertension patients with 2.5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothiazide o.d. In: Progress in Pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 211–20.
12. Boelke T, Achhammer I, Meyer-Sabellek WA. Blutdrucksenkung und metabolische Veranderungen bei essentiellen Hypertonikem nach Langzeitgabe unterschiedlicher Diuretika. Hochdruck 1990; 9: 40–1.
13. Fortuno A, Muniz P, Ravassa S et al. Torasemide inhibits angiotensin II-induced vasoconstriction and intracellular calcium increase in the aorta of spontaneously hypertensive rats. Hypertension 1999; 34: 138–43.
14. Bоеlke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of today 1994; 8: 1–28.
15. Метелица В.И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. 3-е изд. М., 2005. / Metelitsa V.I. Spravochnik po klinicheskoi farmakologii serdechno-sosudistykh lekarstvennykh sredstv. 3-e izd. M., 2005. [in Russian]
16. Patterson J, Adams K, Applefeld M et al. Oral torasemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Torasemide Investigators Group. Pharmacotherapy 1994; 14 (5): 514–21.
17. Cosin J, Diez J and TORIC investigators. Torasemide in chronic heart failure: results of the TORIC study. Eur J Heart Fail 2002; 4 (4): 507–13.
18. Muller K, Gamba G, Jaquet F, Hess B. Torasemide vs. furosemide in primary care patients with chronic heart failure NYHA II to IV – efficacy and quality of life. Eur J Heart Fail 2003; 5 (6): 793–801.
19. Murray M, Deer M, Ferguson J et al. Open-label randomized trial of torasemide compared with furosemide therapy for patients with heart failure. Am J Med 2001; 111 (7): 513–20.
20. Spannheimer A, Muller K, Falkenstein P et al. Long-term diuretic treatment in heart failure: are there differences between furosemide and torasemide? Schweiz Rundsch Med Prax 2002; 91 (37): 1467–75.
21. Мареев В.Ю., Выгодин В.А., Беленков Ю.Н. Диуретическая терапия Эффективными дозами пероральных диуретиков торасемида (диувер) и фуросемида в лечении больных с обострением Хронической Сердечной Недостаточности (ДУЭЛЬ-ХСН). Сердечная недостаточность. 2011; 1: 3–10. / Mareev V.Iu., Vygodin V.A., Belenkov Iu.N. Diureticheskaia terapiia Effektivnymi dozami peroral'nykh diuretikov torasemida (diuver) i furosemida v lechenii bol'nykh s obostreniem Khronicheskoi Serdechnoi Nedostatochnosti (DUEL''-KhSN). Serdechnaia nedostatochnost'. 2011; 1: 3–10. [in Russian]
22. Агеев Ф.Т., Жубрина Е.С., Середенина Е.М. и др. Сравнительная эффективность и безопасность длительного применения торасемида и фуросемида у больных с компенсированной сердечной недостаточностью. Влияние на маркеры фиброза миокарда. Сердечная недостаточность. 2013; 14 (2). / Ageev F.T., Zhubrina E.S., Seredenina E.M. i dr. Sravnitel'naia effektivnost' i bezopasnost' dlitel'nogo primeneniia torasemida i furosemida u bol'nykh s kompensirovannoi serdechnoi nedostatochnost'iu. Vliianie na markery fibroza miokarda. Serdechnaia nedostatochnost'. 2013; 14 (2). [in Russian]
23. Vargo DL, Kramer WG, Black PK et al. Bioavailiability, pharmacokinetics and pharmacodynamics of torasemide and furosemide in patients with congestive heart failure. Clin Pharmacol Ther 1995; 57 (6): 601–9.
24. Guidelines for the diagnosis and treatment of Chronic Heart Failure: full text (update 2005). The Task Force for the diagnosis and treatment of CHF of the European Society of Cardiology.
25. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of chronic heart Failure in the Adult.
26. Risler T, Kramer B, Muller G. The efficacy of diuretics in acute and chronic renal failure. Focus on torasemide. Drugs 1991; 41 (Suppl. 3): 69–79.
27. Kult J, Hacker J, Glocke M. Comparison of efficacy and tolerance of different oral doses of torasemide and furosemide in patients with advanced chronic renal failure. Arznt-Forsch/Drug Res 1998; 38: 212–4.
28. Vasavada N, Saha C, Agarwal R. A double-blind randomized crossover trial of two loop diuretics in chronic kidney disease. Kidney Int 2003; 64 (2): 632–40.
29. Gerbes A, Bertheau-Reitha U, Falkner C et al. Advantages of the new loop diuretic torasemide over furosemide in patients with cirrhosis and ascites. A randomized, double blind cross-over trial. J Hepatol 1993; 17 (3): 353–8.
30. Fiaccadori F, Pedretti G, Pasetti G et al. Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study. Clin Invest 1993; 71 (7): 579–84.
31. Фомин В.В. Свойства антагониста альдостерона у петлевого диуретика: случайность или необходимость? Справ. поликлин. врача. 2010; 4. / Fomin V.V. Svoistva antagonista al'dosterona u petlevogo diuretika: sluchainost' ili neobkhodimost'? Sprav. poliklin. vracha 2010; 4. [in Russian]
32. Моисеев С.В. Клиническая эффективность и безопасность применения петлевого диуретика торасемида. Кардиология. 2006; 4. / Moiseev S.V. Klinicheskaia effektivnost' i bezopasnost' primeneniia petlevogo diuretika torasemida. Kardiologiia. 2006; 4. [in Russian]
33. Gerbes A, Bertheau-Reitha U, Falkner C et al. Advantages of the new loop diuretic torasemide over furosemide in patients with cirrhosis and ascites. A randomized, double blind cross-over trial. J Hepatol 1993; 17 (3): 353–8.
34. Fiaccadori F, Pedretti G, Pasetti G et al. Torasemide versus furosemide in cirrhosis: a long-term, double-blind, randomized clinical study. Clin Invest 1993; 71 (7): 579–84.
35. MDS pharma services Clinical study report. Comparative, randomized, single-dose, 2-way crossover bioavailability study of Polpharma S.A. and Roche (Torem) 10 mg Torasemide tablets in healthy adult volunteers under fasting conditions. Protocol N. AA15312. MDS pharma services project NO. AA15312.
________________________________________________
1. Gorbunov V.M., Oganov R.G. Torasemid – petlevoi diuretik s osobymi svoistvami. Kardiovask. terapiia i profilaktika. 2006; 5 (5). [in Russian]
2. Evdokimova A.G., Kovalenko E.V., Lozhkina M.V. et al. Characteristics of diuretic therapy in chronic heart failure. Consilium Medicum. 2016; 18 (1).
3. Dunn CJ, Fitton A, Brogden RN. Torasemide. Review of its pharmacology and therapeutic use. Drugs 1995; 49: 121–42.
4. Brater DC. Torasemide. In: F.Messerli (ed.). Cardiovascular drug therapy. 2nd edition. Philadelphia, 1996; p. 402–12.
5. Achhammer I, Metz P. Low dose loop diuretics in essential hypertension: Experience with torasemide. Drugs 1991; 41 (Suppl. 3): 80–91.
6. Porcellati C, Verdecchia P, Schillaci G et al. La torasemide, nuovo diuretico del’ansa, nell trattamento dell’ipertensione ar-teriosa: Studio con trolla to in doppla cecita. Bas Razion Terapia 1990; 20: 407–10.
7. Baumgart P, Walger P, Von Eiff M, Achhammer I. Long-term efficacy and tolerance of torasemide in hypertension. In: Progress in pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 169–81.
8. Spannbrucker N, Achhammer I, Metz P, Glocke M. Comparative study on the hypertensive efficacy of torasemide and indapamide in patients with essential hypertension. Drug Res 1988; 38 (1): 190–3.
9. Reyes AJ, Chiesa PD, Santucci MR et al. Hydrochlorothiazide versus a nondiuretic dose of torasemide as once daily antihypertensive monopharmacotherapy in elderly patients; randomized and double-blind study. In: Progress in Pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 183–209.
10. Boelke T, Piesche L. Influence of 2,5–5 mg torasemide o.d. versus 25-50 mg HCTZ/50-100 triamterene o.d. on serum parameters in elderly patients with mild to moderate hypertension. In: Diuretics IV: Chemistry, Pharmacology and clinical Applications. Excerpta Medica: Amsterdam, 1993; p. 279–82.
11. Achhammer I, Eberhard R. Comparison of serum potassium levels during long-term treatment of hypertension patients with 2.5 mg torasemide o.d. or 50 mg triamterene/25 mg hydrochlorothiazide o.d. In: Progress in Pharmacology and Clinical Pharmacology. Gustav-Fischer-Verlag: Stuttgart, 1990; 8: 211–20.
12. Boelke T, Achhammer I, Meyer-Sabellek WA. Blutdrucksenkung und metabolische Veranderungen bei essentiellen Hypertonikem nach Langzeitgabe unterschiedlicher Diuretika. Hochdruck 1990; 9: 40–1.
13. Fortuno A, Muniz P, Ravassa S et al. Torasemide inhibits angiotensin II-induced vasoconstriction and intracellular calcium increase in the aorta of spontaneously hypertensive rats. Hypertension 1999; 34: 138–43.
14. Bоеlke T, Achhammer I. Torasemide: review of its pharmacology and therapeutic use. Drugs of today 1994; 8: 1–28.
15. Metelitsa V.I. Spravochnik po klinicheskoi farmakologii serdechno-sosudistykh lekarstvennykh sredstv. 3-e izd. M., 2005. [in Russian]
16. Patterson J, Adams K, Applefeld M et al. Oral torasemide in patients with chronic congestive heart failure: effects on body weight, edema, and electrolyte excretion. Torasemide Investigators Group. Pharmacotherapy 1994; 14 (5): 514–21.
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Авторы
А.А.Кириченко
ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
andrey.apollonovich@yandex.ru
ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
andrey.apollonovich@yandex.ru
________________________________________________
A.A.Kirichenko
Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
andrey.apollonovich@yandex.ru
Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. 125995, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
andrey.apollonovich@yandex.ru
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