Ethacrynic acid (uregit)
Pharmacokinetics . Uregit is perfectly absorbed through the intestinal walls. In the first minutes after administration, it actively binds to blood proteins. The therapeutic effect can occur 20-35 minutes after administration. The effect lasts about 4-8 hours and its maximum occurs 1-2 hours after administration. If the drug is administered intravenously, the effect is observed 5-10 minutes after the start of administration and reaches its maximum after 15-25 minutes. It lasts 2-3 hours.
Pharmacodynamics . Ethacrynic acid or uregit has a fairly high diuretic activity, acts at the level of basal cells, of course, the tubular epithelium. To be more precise, in that part of the loop of Henele, which is considered ascending. The activity of those enzymes. Which participate in energy formation, the acid blocks the activity, which affects the work of the pumps, in particular the one that provides maximum reabsorption of Sodium plus and SG on the basement membrane. Sensitivity to vasopressing is effectively reduced by ethacrynic acid. If used for a long time, it should affect the reduction of blood pressure. In case of poisoning with chlorides, bromides, iodides, it accelerates their elimination from the body, which has a positive effect on the patient’s condition during the administration of these minerals by products.
Indications for use . Edema of the brain, lungs, arterial hypertension, cirrhosis of the liver with portal hypertension, acute poisoning. Acute and chronic renal failure.
Side effects . Due to the moderate excretion of potassium and magnesium, hypokalemia and hypomagnesemia are possible with prolonged use. A decrease in the excretion of uric acid and hypochloremic alkalosis are also observed. Reversible ototoxic hyperkalemia. Pain in the colon, pain in the esophagus, dyspeptic phenomena are possible and often observed. All this as a result of the irritating effect of the drug itself. After intravenous injection, pain syndrome along the vein or phlebitis may occur. To avoid this, the drug should be pre-diluted in isotonic sodium chloride solution. The rate of administration should be low.
Furosemil
Furosemil or its analogues such as lasix, fumarenide, furantril, fusid, durafiride, furo-puren, yena-fusid, furo-raciopharm, furosemide-stada, furorese, furosemide-raciopharm, hydro-rapid, edemaze, sigazalur, durafuride, fusid and others. They belonged to the chemical structure of four-chloro-EN-(two-furylmethyl)-five-sulfamoylanthranilic acid. Including and like many other drugs of this group, the above-mentioned together with furasemide, contain in their structure of the molecule a sulfonamide group.
Pharmacokinetics. The drug is very well reabsorbed in the intestine by about 55-77%. If the drug is taken orally, the effect is expected in 33-55 minutes after the moment of administration. The maximum effect is in an hour or two after administration and lasts for six to eight hours. If the drug is administered intravenously, the effect occurs much faster, in about 5-9 minutes and lasts for about two to four hours. The maximum effect with intravenous administration is achieved in 20-55 minutes. This drug has proven itself very well for its fast and powerful action in emergency medical care. The drug is metabolized in the liver by 50% in about half an hour to an hour after administration. The filtration path of the drug is through the kidneys in the cups and secretions. If the patient suffers from renal failure, half of the drug is excreted much more slowly, in about 8-15 hours.
Pharmacodynamics . Furosemide, of course, can produce a comprehensive effect on the cells of the renal tubules. Activity of enzymes such as hexokinase, Na+, K+-ATPase, malate and succinate dehydrogenase. Energy supply in this regard, the above-mentioned sodium pump becomes insufficient. As for the active reabsorption of sodium and chlorine, the drug actively inhibits them in the segment called thick, the loop of Henele. At the reverse membrane, the drug increases the reverse permeability of cells to sodium-plus. As a result, the flow of passive sodium increases from the intercellular fluid, and the intracellular pool of sodium-plus increases. This reduces the penetration of sodium from the canalicular lumens. The drug stimulates renal blood flow and especially enhances the excretion of calcium, magnesium, phosphates, potassium and hydrocarbonates.
Furosemide has an increasing effect on the level of prostaglandins and kinins. This improves the general hemodynamics of the kidneys and increases the excretion of sodium with urine. This drug retains uric acid in the body. The effect on blood pressure, namely its reduction, is associated with the excretion of sodium and limitation of the sensitivity of the vascular wall to catecholamines.
Indications for use . In case of cerebral or mild edema, furosemide is prescribed due to its very good sodium-excreting function. It is also commonly prescribed to enhance diuresis in acute poisoning or other intoxications. The drug is also actively used in combination with antihypertensive drugs to reduce blood pressure.
Side effects . If large doses are prescribed, this can lead to a decrease in the volume of circulating arterial blood. If taken for a long time, complications such as hypokalemia, metabolic alkalosis, and hypochloremia may occur. If there is increased excretion of uric acid, exacerbations of gout are possible. Hyperglycemia sometimes occurs.
