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Rasitol
injection 10mg/ml (2ml/amp.)/ Rasitol 40mg/Tab. Tablet (Furosemide)
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| 品名規格 | Rasitol injection 20mg/amp. | Rasitol 40mg/Tab. Tablet |
| 廠 商 | 永信製藥廠 | |
| 代 號 | ILAS | OLAS |
| 成 份 名 | Furosemide 20mg/amp. | Furosemide 40mg/Tab. |
| 中文名稱 | 來喜妥注射液 | 來喜妥錠４０公絲 |
| 藥理分類 | Diuretic agents | |
| 外
觀
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| 品名規格 | Colonraitai 25mg/Tab. |
| 廠 商 | 井田製藥工業股份有限公司 |
| 代 號 | ODICH |
| 成 份 名 | Dihydrochlorothiazide 25mg/Tab. |
| 中文名稱 | 克隆來泰錠 |
| 藥理分類 | Diuretic agents |
| 外 觀 |   |
利尿、高血壓
Dihydrochlorothiazid Dosage Forms
Tablet (oral)
Dihydrochlorothiazid Indication
For the treatment of high blood pressure and
management of edema.
Dihydrochlorothiazid Pharmacology
Thiazides such as hydrochlorothiazide promote water
loss from the body (diuretics). They inhibit Na+/Cl-
reabsorption from the distal convoluted tubules in
the kidneys. Thiazides also cause loss of potassium
and an increase in serum uric acid. Thiazides are
often used to treat hypertension, but their
hypotensive effects are not necessarily due to their
diuretic activity. Thiazides have been shown to
prevent hypertension-related morbidity and mortality
although the mechanism is not fully understood.
Thiazides cause vasodilation by activating
calcium-activated potassium channels (large
conductance) in vascular smooth muscles and
inhibiting various carbonic anhydrases in vascular
tissue.
Dihydrochlorothiazid Absorption
50-60%
Dihydrochlorothiazid side effects and Toxicity
The most common signs and symptoms observed are
those caused by electrolyte depletion (hypokalemia,
hypochloremia, hyponatremia) and dehydration
resulting from excessive diuresis. If digitalis has
also been administered, hypokalemia may accentuate
cardiac arrhythmias. The oral LD50 of
hydrochlorothiazide is greater than 10 g/kg in the
mouse and rat.
Dihydrochlorothiazid Patient Information
General
All patients receiving diuretic therapy should be observed for evidence of fluid or electrolyte imbalance: namely, hyponatremia, hypochloremic alkalosis, and hypokalemia. Serum and urine electrolyte determinations are particularly important when the patient is vomiting excessively or receiving parenteral fluids. Warning signs or symptoms of fluid and electrolyte imbalance, irrespective of cause, include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbance such as nausea or vomiting. Hypokalemia may develop, especially with brisk diuresis, when severe cirrhosis is present or after prolonged therapy. Interference with adequate oral electrolyte intake will also contribute to hypokalemia. Hypokalemia may cause cardiac arrhythmia and may also sensitize or exaggerate the response of the heart to the toxic effects of digitalis (e.g., increased ventricular irritability). Hypokalemia may be avoided or treated by use of potassium sparing diuretics or potassium supplements such as foods with a high potassium content. Although any chloride deficit is generally mild and usually does not require specific treatment except under extraordinary circumstances (as in liver disease or renal disease), chloride replacement may be required in the treatment of metabolic alkalosis. Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life threatening. In actual salt depletion, appropriate replacement is the therapy of choice. Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazides. In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required. Hyperglycemia may occur with thiazide diuretics. Thus latent diabetes mellitus may become manifest during thiazide therapy. The antihypertensive effects of the drug may be enhanced in the post-sympathectomy patient. If progressive renal impairment becomes evident, consider withholding or discontinuing diuretic therapy. Thiazides have been shown to increase the urinary excretion of magnesium; this may result in hypomagnesemia. Thiazides may decrease urinary calcium excretion. Thiazides may cause intermittent and slight elevation of serum calcium in the absence of known disorders of calcium metabolism. Marked hypercalcemia may be evidence of hidden hyperparathyroidism. Thiazides should be discontinued before carrying out tests for parathyroid function. Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy. Laboratory Tests Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals.
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Indap S.R. 1.5mg/Tab. (Indapamide 1.5mg / Tab.)
非thiazide系降壓劑 Indapamide
S.R.
1.5 mg/Tablet
【組
成】Each Tablet Contains:
Indapamide
1.5 mg 【適應症】高血壓。
【用
法】
1日1粒，早飯後依症狀適宜增減，本藥須由醫師處方使用。
【注
意】 1.一般的注意: a.因急激產生利尿效果，以致須十分注意電解質失調，脫水現象。開始時，少量投與，以後慢
慢增加。
b.持續使用時，會有電解質失調現象，須定期檢查。
2.禁忌:
a.無尿患者。
b.急性腎不全患者。
c.體液中的鈉、鉀，明顯減少之患者。 d.對Thiazide系藥劑及其類似化合物(例如Chloro Thiazide等的Sulfonamide誘導體)會引起過敏症之既
往病歷患者。 3.慎重投與:
a.肝硬變症患者(有誘發肝性昏睡狀況發生)。
b.有心疾患之高齡者，嚴重冠硬化症、腦動脈硬化症患者。
c.嚴重腎障害患者。
d.肝疾患、肝機能障害患者。
e.本人及兩親、兄弟有痛風及糖尿病患者。
f.下痢、嘔吐患者。
g.高鈣血症、副甲狀腺機能高進症患者。
h.Digitalis劑、糖質副腎皮質賀爾蒙劑、ACTH投與受影響患者。
j.乳兒。
k.交感神經切除後之患者。
4.副作用:血小板減少、肝機能異常、代謝異常、發疹、顏面紅潮、光線過敏症、食慾不振、噁心、
嘔吐、口渴、便秘、胃部不快感、頭痛、頭重、耳鳴。
5.妊婦、授乳婦投與;妊娠後期及授乳中婦人避兔使用。
6.小兒投與:對小兒安全性未確立。
7.相互作用:併用其他降壓劑，會增強降壓作用，須注意降壓劑用量調節。
8.臨床檢查值之影響:對無甲狀腺障害患者之血清PBI有低下可能，須注意。
【作
用】 1.藥效藥理:降壓作用、抑制血管平滑筋收縮反應、利尿作用。
2.體內藥物動態: a．單回投與:健康成人男子24名，單回經口投與2mg和4mg，約2小時後最高血中濃度84ng/ml，
177ng/ml，半衰期7.5-10.5小時。 b．連續投與:健康成人男子11名，連續經口投與2mgl日1回2星期，血中濃度在開始之第4日達最 高約110-125ng/ml，最低約25-45ng/ml，本態性高血壓患者1日1回2mg或3mg約1年間投與時的
最高血中濃度平均值117ng/ml，165ng/ml。
3.臨床適用:
a.降壓效果:本態性高血壓症70．9%，長期投與有良好持續的降壓效果。 b.副作用及臨床檢查值的變動:副作用有6.5%，在中止後又投與繼續中消失。臨床檢查值的變 動，血清鉀值低下4.3%，尿酸值上昇4.2%，空腹時血糖值上昇1.3%。
4.非臨床試驗: 毒性: a.LD50(mg/kg)
b.特殊毒性:生殖試驗、抗原性、變異原性、致癌性未確認。 c.吸收、分布、代謝、排泄:動物試驗經口投與後3Omg/kg完全吸收，分布肝、腎，4日後42.4-54.8%
由糞便排出17.2-30.1%由尿中排泄。 d.一般藥理:降壓、利尿作用以外的中樞神經系、消化系、自律神經系等作用。
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新品(Spiron
25mg/Tab.)
舊品(Aldactin
25mg/Tab.)
新品
舊品
