呋塞米片说明书

呋塞米片说明 【药品名称】 通用名:呋塞米片 曾用名: 商品名: 英文名:Furosemide Tablets 汉语拼音:Fusaimi Pian 本品主要成分及其化学名称为:主要成分:呋塞米 化学名称:2-[(2-呋喃甲基)氨基]-5-(氨磺酰基)-4-氯苯甲酸。 其结构式为: 分子式:CHClNOS 121125 分子量:330.74 【性状】 本品为无色片。 【药理毒理】 (1)对水和电解质排泄的作用。能增加水、钠、氯、钾、钙、镁、磷等的排泄。与噻嗪类利尿药不同，呋塞米等袢利尿药存在明显的剂量,效应关系。随着剂量加大，利尿效果明显增强，且药物剂量范围较大。本类药物主要通过抑制肾小管髓袢厚壁段对NaCl的主动重吸收， ，,，,结果管腔液Na、C1浓度升高，而髓质间液Na、Cl浓度降低，使渗透 ，,压梯度差降低，肾小管浓缩功能下降，从而导致水、Na、Cl排泄增多。for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet ++++++由于Na重吸收减少，远端小管Na浓度升高，促进Na-K和Na-H交换 ++增加，K和H排出增多。至于呋塞米抑制肾小管髓袢升支厚壁段重吸收Cl,的机制，过去曾认为该部位存在氯泵，目前研究表明该部位基底膜外侧存 ，，，,在与Na-KATP酶有关的Na、Cl配对转运系统，呋塞米通过抑制该系统 ，,功能而减少Na、C1的重吸收。另外，呋塞米可能尚能抑制近端小管和远 ，,，端小管对Na、Cl的重吸收，促进远端小管分泌K。呋塞米通过抑制亨氏 2，2，2，2，袢对Ca、Mg的重吸收而增加Ca、Mg排泄。短期用药能增加尿酸排泄，而长期用药则可引起高尿酸血症。 (2)对血流动力学的影响。呋塞米能抑制前列腺素分解酶的活性，使前列腺素E含量升高，从而具有扩张血管作用。扩张肾血管，降低肾血管阻2 力，使肾血流量尤其是肾皮质深部血流量增加，在呋塞米的利尿作用中具有重要意义，也是其用于预防急性肾功能衰竭的理论基础。另外，与其他利尿药不同，袢利尿药在肾小管液流量增加的同时肾小球滤过率不下降，可能与流经致密斑的氯减少，从而减弱或阻断了球-管平衡有关。呋塞米能扩张肺部容量静脉，降低肺毛细血管通透性，加上其利尿作用，使回心血量减少，左心室舒张末期压力降低，有助于急性左心衰竭的治疗。由于呋塞米可降低肺毛细血管通透性，为其治疗成人呼吸窘迫综合征提供了理论依据。 【药代动力学】 口服吸收率为60%~70%，进食能减慢吸收，但不影响吸收率及其疗效。终末期肾脏病患者的口服吸收率降至43%~46%。充血性心力衰竭和肾病综合征等水肿性疾病时，由于肠壁水肿，口服吸收率也下降，故在上述情况应肠外途径用药。主要分布于细胞外液，分布容积平 three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation syrity technology prevention system security monitoring system out entrance control system car library management system hours secu nd the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part)facilities system integrated wiring system (containing room network, communications part) wired TV system information guide a 471 2. system description this times engineering weak design including: hours a Kok information-92 intelligent building weak design construction figure set GJBT -2000 of electrical installations code for construction and acceptance of GBJ232-ring GB/T50314for computer software enginee2to the Communications Board within the chassis to meet controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access-tal programindependent integrated services digi-cation system using a local telecommunications operator providing voice service, configurationd voice communications systems Center of information on medical floor computer room located in the engine room. Voice communiems anem of information system (1) cabling systems (including computer room network, communication component) computer network systperation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated syststem o 均为体重的11.4%，血浆蛋白结合率为91%~97%，几乎均与白蛋白结合。本药能通过胎盘屏障，并可泌入乳汁中。口服和静脉用药后作用开始时间分别为30~60分钟和5分钟，达峰时间为1~2小时和0.33~1小时。作用持续时间分别为6~8小时和2小时。Tβ存在较大的个体差异，正常人为1/2 30~60分钟，无尿患者延长至75~155分钟，肝肾功能同时严重受损者延长至11~20小时。新生儿由于肝肾廓清能力较差，Tβ延长至4~8小时。88%,12 以原形经肾脏排泄，12%经肝脏代谢由胆汁排泄。肾功能受损者经肝脏代谢增多。本药不被透析清除。 【适应症】 1.水肿性疾病 包括充血性心力衰竭、肝硬化、肾脏疾病(肾炎、肾病及各种原因所致的急、慢性肾功能衰竭)，尤其是应用其他利尿药效果不佳时，应用本类药物仍可能有效。与其他药物合用治疗急性肺水肿和急性脑水肿等。 2.高血压 在高血压的阶梯疗法中，不作为治疗原发性高血压的首选药物，但当噻嗪类药物疗效不佳，尤其当伴有肾功能不全或出现高血压危象时，本类药物尤为适用。 3.预防急性肾功能衰竭 用于各种原因导致肾脏血流灌注不足，例如失水、休克、中毒、麻醉意外以及循环功能不全等，在纠正血容量不足的同时及时应用，可减少急性肾小管坏死的机会。 4.高钾血症及高钙血症。 5.稀释性低钠血症 尤其是当血钠浓度低于120mmol/L时。 6.抗利尿激素分泌过多症(SIADH)。 7.急性药物毒物中毒 如巴比妥类药物中毒等。 3munications Board within the chassis to meetswitchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Comcontrolled -independent integrated services digital program-ocal telecommunications operator providing voice service, configurationsystems Center of information on medical floor computer room located in the engine room. Voice communication system using a ltions m (1) cabling systems (including computer room network, communication component) computer network systems and voice communicaitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information systeem monpment monitoring system hours four Kok information application system queued station ICU visitation system operation the systion system security monitoring system out entrance control system car library management system hours three Kok building equieventhours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology pr grated wiring system (containing room network, communications part) wired TV system information guide and the released system471 2. system description this times engineering weak design including: hours a Kok information facilities system inte-92 intelligent building weak design construction figure set GJBT -electrical installations code for construction and acceptance of GBJ2322000 of -for computer software engineering GB/T50314 【用法与用量】 1.成人 (1)治疗水肿性疾病。起始剂量为口服20~40mg，每日1次，必要时6~8小时后追加20~40mg，直至出现满意利尿效果。最大剂量虽可达每日600mg，但一般应控制在100mg以内，分2,3次服用。以防过度利尿和不良反应发生。部分患者剂量可减少至20,40mg，隔日1次，或每周中连续服药2,4日，每日20,40mg。 (2)治疗高血压。起始每日40,80mg，分2次服用，并酌情调整剂量。 (3)治疗高钙血症。每日口服80,120mg，分1,3次服。 2.小儿 治疗水肿性疾病，起始按体重2mg/kg，口服，必要时每4,6小时追加1,2mg/kg。 新生儿应延长用药间隔。 【不良反应】 常见者与水、电解质紊乱有关、尤其是大剂量或长期应用时，如体位性低血压、休克、低钾血症、低氯血症、低氯性碱中毒、低钠血症、低钙血症以及与此有关的口渴、乏力、肌肉酸痛、心律失常等。 少见者有过敏反应(包括皮疹、间质性肾炎、甚至心脏骤停)、视觉模糊、黄视症、光敏感、头晕、头痛、钠差、恶心、呕吐、腹痛、腹泻、胰腺炎、肌肉强直等，骨髓抑制导致粒细胞减少，血小板减少性紫癜和再生障碍性贫血，肝功能损害，指(趾)感觉异常，高糖血症，尿糖阳性，原有糖尿病加重，高尿酸血症。耳鸣、听力障碍多见于大剂量静脉快速注射时(每分钟剂量大于4~15mg)，多为暂时性，少数为不可逆性，尤其当与其他有耳毒性的药物同时应用时。在高钙血症时，可引起肾结石。尚有报道本药可加重特发性水肿。 three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation syrity technology prevention system security monitoring system out entrance control system car library management system hours secu nd the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part)facilities system integrated wiring system (containing room network, communications part) wired TV system information guide a 471 2. system description this times engineering weak design including: hours a Kok information-92 intelligent building weak design construction figure set GJBT -2000 of electrical installations code for construction and acceptance of GBJ232-ring GB/T50314for computer software enginee4to the Communications Board within the chassis to meet controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access-tal programindependent integrated services digi-cation system using a local telecommunications operator providing voice service, configurationd voice communications systems Center of information on medical floor computer room located in the engine room. Voice communiems anem of information system (1) cabling systems (including computer room network, communication component) computer network systperation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated syststem o 【注意事项】 (1)交叉过敏。对磺胺药和噻嗪类利尿药过敏者，对本药可能亦过敏。 (2)对诊断的干扰:可致血糖升高、尿糖阳性，尤其是糖尿病或糖尿病 ，,+前期患者,过度脱水可使血尿酸和尿素氮水平暂时性升高。血Na、Cl、K、 2+2+Ca和Mg浓度下降。 (3)下列情况慎用:?无尿或严重肾功能损害者，后者因需加大剂量，故用药间隔时间应延长，以免出现耳毒性等副作用;?糖尿病;?高尿酸血症或有痛风病史者;?严重肝功能损害者，因水电解质紊乱可诱发肝昏迷;?急性心肌梗死，过度利尿可促发休克;?胰腺炎或有此病史者;?有低钾血症倾向者，尤其是应用洋地黄类药物或有室性心律失常者;?红斑狼疮，本药可加重病情或诱发活动;?前列腺肥大。 (4)随访检查:?血电解质，尤其是合用洋地黄类药物或皮质激素类药物、肝肾功能损害者;?血压，尤其是用于降压，大剂量应用或用于老年人;?肾功能;?肝功能;?血糖;?血尿酸;?酸碱平衡情况;?听力。 (5)药物剂量应从最小有效剂量开始，然后根据利尿反应调整剂量，以减少水、电解质紊乱等副作用的发生。 (6)存在低钾血症或低钾血症倾向时，应注意补充钾盐。 (7)与降压药合用时，后者剂量应酌情调整。 (8)少尿或无尿患者应用最大剂量后24小时仍无效时应停药。 【孕妇及哺乳期妇女用药】 (1)本药可通过胎盘屏障，孕妇尤其是妊娠前3个月应尽量避免应用。对妊娠高血压综合征无预防作用。动物实验表明本品可致胎仔肾盂积水， em monpment monitoring system hours four Kok information application system queued station ICU visitation system operation the systion system security monitoring system out entrance control system car library management system hours three Kok building equieventhours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology pr grated wiring system (containing room network, communications part) wired TV system information guide and the released system471 2. system description this times engineering weak design including: hours a Kok information facilities system inte-92 intelligent building weak design construction figure set GJBT -electrical installations code for construction and acceptance of GBJ2322000 of -for computer software engineering GB/T503145munications Board within the chassis to meetswitchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Comcontrolled -independent integrated services digital program-ocal telecommunications operator providing voice service, configurationsystems Center of information on medical floor computer room located in the engine room. Voice communication system using a ltions m (1) cabling systems (including computer room network, communication component) computer network systems and voice communicaitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information syste 流产和胎仔死亡率升高。 (2)本药可经乳汁分泌，哺乳期妇女应慎用。 【儿童用药】 本药在新生儿的半衰期明显延长，故新生儿用药间隔应延长。 【老年患者用药】 老年人应用本药时发生低血压、电解质紊乱，血栓形成和肾功能损害的机会增多。 【药物相互作用】 (1)肾上腺糖、盐皮质激素，促肾上腺皮质激素及雌激素能降低本药的利尿作用，并增加电解质紊乱尤其是低钾血症的发生机会。 (2)非甾体类消炎镇痛药能降低本药的利尿作用，肾损害机会也增加，这与前者抑制前列腺素合成，减少肾血流量有关。 (3)与拟交感神经药物及抗惊厥药物合用，利尿作用减弱。 (4)与氯贝丁酯(安妥明)合用，两药的作用均增强，并可出现肌肉酸痛、强直。 (5)与多巴胺合用，利尿作用加强。 (6)饮酒及含酒精制剂和可引起血压下降的药物能增强本药的利尿和降压作用;与巴比妥类药物、麻醉药合用，易引起体位性低血压。 (7)本药可使尿酸排泄减少，血尿酸升高，故与治疗痛风的药物合用时，后者的剂量应作适当调整。 (8)降低降血糖药的疗效。 (9)降低抗凝药物和抗纤溶药物的作用，主要是利尿后血容量下降，致血中凝血因子浓度升高，以及利尿使肝血液供应改善、肝脏合成凝血因 cation system using a local telecommunications operator providing voice service, configurationd voice communications systems Center of information on medical floor computer room located in the engine room. Voice communiems anem of information system (1) cabling systems (including computer room network, communication component) computer network systperation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated syststem othree Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation syrity technology prevention system security monitoring system out entrance control system car library management system hours secu nd the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part)facilities system integrated wiring system (containing room network, communications part) wired TV system information guide a 471 2. system description this times engineering weak design including: hours a Kok information-92 intelligent building weak design construction figure set GJBT -2000 of electrical installations code for construction and acceptance of GBJ232-ring GB/T50314for computer software enginee6to the Communications Board within the chassis to meet controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access-tal programindependent integrated services digi- 子增多有关。 (10)本药加强非去极化肌松药的作用，与血钾下降有关。 (11)与两性霉素、头孢霉素、氨基糖苷类等抗生素合用，肾毒性和耳毒性增加，尤其是原有肾损害时。 (12)与抗组胺药物合用时耳毒性增加，易出现耳鸣、头晕、眩晕。 (13)与锂合用肾毒性明显增加，应尽量避免。 (14)服用水合氯醛后静注本药可致出汗、面色潮红和血压升高，此与甲状腺素由结合状态转为游离状态增多，导致分解代谢加强有关。 (15)与碳酸氢钠合用发生低氯性碱中毒机会增加。 【规格】 20mg 【贮藏】 遮光，密封，置干燥处保存。 【包装】 【有效期】 【批准文号】 【生产企业】 企业名称: 地址: 邮政编码: 电话号码: 传真号码: 网址: systems Center of information on medical floor computer room located in the engine room. Voice communication system using a ltions m (1) cabling systems (including computer room network, communication component) computer network systems and voice communicaitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information systeem monpment monitoring system hours four Kok information application system queued station ICU visitation system operation the systion system security monitoring system out entrance control system car library management system hours three Kok building equieventhours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology pr grated wiring system (containing room network, communications part) wired TV system information guide and the released system471 2. system description this times engineering weak design including: hours a Kok information facilities system inte-92 intelligent building weak design construction figure set GJBT -electrical installations code for construction and acceptance of GBJ2322000 of -for computer software engineering GB/T503147munications Board within the chassis to meetswitchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Comcontrolled -independent integrated services digital program-ocal telecommunications operator providing voice service, configuration