新型袢利尿剂托拉塞米

Torasemide,a new loop diuretics

综述托拉塞米的药理作用、药动学、临床应用、药物不良反应和药物经济学。托拉塞米属吡啶磺酰脲类袢利尿剂,作用于髓袢升支粗段,抑制Cl^-和Na^+的重吸收,产生利尿、利钠和其他作用。其生物利用度高,半衰期相对较长,血浆蛋白结合率较高。临床试验表明,托拉塞米治疗高血压和慢性肾功能衰竭、肝功能不全或心力衰竭患者的水肿和其他症状有效,不良反应较轻。药物经济学分析表明,托拉塞米通过降低住院率和再住院率而降低总花费。

The pharmacology, pharmacokinetics, clinical eff icacy, adverse effects, and pharmaco economics of torasemide are reviewed. Torasemide belongs to the pyridine-sulfonylurea class of loop diuretics. Its primary site of activity is the thick ascending limb of the loop of Henle, where it blockes active reaborption of sodium and chloride, resulting in diuresis, natriuresis, and other effects. Torasemide has high bioavailability,a relatively long half-life. It is highly protein bound. Clinical trials indicate that torasemide is effective in the treatment of hypertension and of edema and other symptoms in patients with chronic renal failure,hepatic dysfunction,or congestive heart failure(CHF) . Torasemide has mild, adverse effects. Pharmacoeconomic analysis has shown that torasemide is likely to reduce overall treatment costs of CHF by reducing hospital admission and readmission.