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Торасемид – препарат для терапии сердечной недостаточности и артериальной гипертензии
Торасемид – препарат для терапии сердечной недостаточности и артериальной гипертензии
Трухан Д.И., Давыдов Е.Л. Торасемид – препарат для терапии сердечной недостаточности и артериальной гипертензии. Consilium Medicum. 2019; 21 (10): 40–47. DOI: 10.26442/20751753.2019.10.190549
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Аннотация
Актуальной проблемой здравоохранения является оптимизация лекарственной терапии у пациентов с хронической сердечной недостаточностью (ХСН) и артериальной гипертензией. В настоящее время основным показанием для петлевых диуретиков является ХСН. К преимуществам петлевого диуретика торасемида в сравнении с фуросемидом относятся: 1) торасемид в 4 раза «сильнее» по дозированию; 2) более стабильная (предсказуемая) биодоступность, не зависящая от приема пищи и состояния кишечной стенки (актуально при застойной ХСН); 3) период полувыведения (Т1/2) торасемида в 4 раза выше; 4) при хронической почечной недостаточности Т1/2 не изменяется (метаболизм в печени 80%); 5) дополнительные эффекты торасемида на ренин-ангиотензин-альдостероновую систему – ангиотензин II и рецепторы к альдостерону. Благодаря безопасному метаболическому профилю и многофакторному антигипертензивному действию торасемид расширяет возможности использования петлевых диуретиков в комплексной антигипертензивной терапии. Наличие в арсенале практического врача торасемида позволяет оптимизировать лекарственную терапию у пациентов с ХСН и артериальной гипертензией.
Ключевые слова: хроническая сердечная недостаточность, артериальная гипертензия, торасемид.
Ключевые слова: хроническая сердечная недостаточность, артериальная гипертензия, торасемид.
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The current problem of public health is the optimization of drug therapy in patients with chronic heart failure and hypertension. Torasemide expands the use of loop diuretics in complex antihypertensive therapy due to a safe metabolic profile and multifactorial antihypertensive action. An urgent public health problem is the optimization of drug therapy in patients with chronic heart failure and arterial hypertension. Currently, the main indication for loop diuretics is chronic heart failure (CHF). The advantages of the torasemide loop diuretic compared to furosemide include: 1) torasemide is 4 times “stronger” in dosage; 2) a more stable (predictable) bioavailability, independent of food intake and the condition of the intestinal wall (relevant for congestive heart failure); 3) the half-life of torasemide (T1/2) is 4 times higher; 4) in chronic renal failure, T1/2 does not change (metabolism in the liver 80%); 5) additional effects of torasemide on renin-angiotensin-al-dosterone system – angiotensin II and aldosterone receptors. Due to its safe metabolic profile and multifactorial antihypertensive effect, torasemide expands the possibilities of using loop diuretics in complex antihypertensive therapy. The presence in the arsenal of the practitioner of the most famous drug torasemide allows optimizing drug therapy in patients with heart failure and arterial hypertension.
Key words: chronic heart failure, аrterial hypertension, torasemide.
Key words: chronic heart failure, аrterial hypertension, torasemide.
Полный текст
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Авторы
Д.И. Трухан*1, Е.Л. Давыдов2
1 ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия;
2 ФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого», Красноярск, Россия
*dmitry_trukhan@mail.ru
1 Omsk State Medical University, Omsk, Russia;
2 Voino-Yasenetski Krasnoyarsk State Medical University, Krasnoyarsk, Russia
*dmitry_trukhan@mail.ru
1 ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия;
2 ФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого», Красноярск, Россия
*dmitry_trukhan@mail.ru
________________________________________________
1 Omsk State Medical University, Omsk, Russia;
2 Voino-Yasenetski Krasnoyarsk State Medical University, Krasnoyarsk, Russia
*dmitry_trukhan@mail.ru
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