
chlortidone

chlortlidone, jise chlorthalidone key roop mein bhee jaanaa jaataa haye, ack thiazide jaisi mootravardhak dawa haye jiska upayog uchch raktchaap, soojan (jaise hriday kii viphalata, yakrit kii viphalata aur nephrotic syndrome mein hotaa haye), madhumeh insipidus aur renal tubeler acidosis key ilaaj key liye kiya jaataa haye. kyonki chlortlidone uchch raktchaap vaale adhikansh rogiyon mein vishvasaniya roop seey prabhaavi haye, ise ack pasandida praarambhik upchaar maanaa jaataa haye. iska upayog calcium adharit gurde kii pathri koo rokane key liye bhee kiya jaataa haye. ise munh seey liya jaataa haye. prabhaav aam taur parr teen ghante key bheetar shuru hoe jaataa haye aur teen dinon taka rahata haye. dill key daure yaa stroke kii roktham key liye hydrochlorothiagide kii tulanaa mein chlortidone key saath deerghakaalik upchaar adhik prabhaavi haye.
samanya pratikool prabhaavon mein cumm rakt potasium, cumm rakt sodium, uchch rakt sharkara, chakkar aanaa aur stambhan dosh shamil hain. anya pratikool prabhaavon mein gathiya, cumm rakt magnicium, uchch rakt calcium, allergy pratikriyaen aur cumm raktchaap shamil hoe sakate hain. kuchh sameekshaon mein chlortlidone aur hydrochlorothiagide mein pratikool prabhaavon kaa samaan jokhim paaya gayaa haye, jabaki anya sameekshaon mein chlortlidone mein uchch jokhim paaya gayaa haye. jabaki iska upayog garbhavastha mein kiya jaa sakata haye, yeh ack cumm pasandida vikalp haye. yeh kaise kaam kartaa haye yeh poori tarah seey spasht naheen haye, lekin maanaa jaataa haye kii isamen gurde dwara khoye gaye sodium aur paani kii matra koo badhaana shamil haye.
chlortlidone koo 1957 mein patent karaaya gayaa thaa aur 1960 mein chikitsa upayog mein aaya thaa. yeh vishva swaasthya sangathan kii aavashyak davaaon kii soochi mein haye. yeh ack samanya dawa key roop mein upalabdh haye. 2020 mein, yeh sanyukt raajya mein 133veen sabse adhik nirdhaarit dawa thee, jisamen 4 million seey adhik prescription they.
chikitsa upayog.
uchch raktchaap.
chlortlidone koo uchch raktchaap key upchaar key liye pahali pankti kii dawa maanaa jaataa haye. kuchh loga hydrochlorothiazide parr chlortalidone kii salah dete hain. yaadrichhik niyantrit parikshanon key ack metaa-vishleshan mein paaya gayaa kii raktchaap koo cumm karane key liye chlortidone hydrochlorothiazide kii tulanaa mein adhik prabhaavi haye, jabaki donon davaaon mein samaan vishaaktata haye.
uchch raktchaap key liye chlortlidone key parikshanon mein paaya gayaa kii chlortlidone kii cumm khuraak (ee.jee., sabhi adhyayan mein dainik 12.5 milligram) kaa adhikatam raktchaap cumm karane kaa prabhaav thaa aur yeh kii uchch khuraak ney ise adhik cumm naheen kiya. chlortlidone aur anya thiazide mootravardhak deerghakaalik gurde kii bimari vaale vyaktiyon mein uchch raktchaap koo cumm karane key liye prabhaavi hain, halanki inn vyaktiyon mein pratikool prabhaavon kaa khatra adhik haye. 
baaen nilay atishoth.
chlortlidone kaa upayog hriday mein baaen nilay uchch raktchaap key ilaaj key liye kiya jaataa haye; yeh mukhya roop seey raktchaap koo cumm karke kaam kartaa haye, aur iss tarah pranaaleegat samvahani pratirodh koo cumm kartaa haye. iss baat key pramaan hain kii chlortlidone hriday key baaen nilay key vistaar vaale vyaktiyon mein hriday key baaen nilay key dravyamaan koo cumm karane key liye hydrochlorothiazide seey behtar haye. chlortlidone baaen nilay key vistaar key pratigaman koo prerit karane key liye angiotensin parivartit enzyme avarodhak yaa angiotensin II receptor blockers seey behtar haye, joe hriday kaa mukhya pumping kaksh haye.
soojan.
chlortlidone mootra namak aur paani key utsarjan koo badhaakar, intravascular hydrostatic dabaav koo cumm karke aur iss tarah transcapillary dabaav koo cumm karke shoth (soojan) koo cumm kartaa haye (starling sameekaran dekhein). shoth yaa tou hydrostatic dabaav mein vriddhi yaa rakt vaahikaon mein oncotic dabaav mein kamee key kaaran hoe sakata haye. hydrostatic dabaav mein vriddhi key kaaran shoth gambhir cardiopulmonary roga (joe gurde mein glomerular perfusion koo cumm kartaa haye) yaa gurde kii chot yaa bimari (joe gurde dwara namak aur paani key glomerular utsarjan koo cumm curr sakata haye) yaa masik dharm seey sambandhit drav pratidhaaran jaisi apekshaakrit saumya sthitiyon key kaaran hoe sakata haye, yaa dihydropyridine calcium channel blockers key pratikool prabhaav key roop mein hoe sakata haye, joe aamtaur parr pairon aur nichale pairon kii soojan kaa kaaran banata haye. oncotic dabaav mein kamee key kaaran shoth ack ghayal gurde key glomeruli key madhyam seey rakt protein key risaav kaa parinam hoe sakata haye yaa kshatigrast yakrit dwara rakt protein key cumm sanshleshan kaa parinam hoe sakata haye. kaaran kii parwah kiye binaa, chlortlidone intravascular matra koo cumm karke aur iss tarah intravascular hydrostatic dabaav koo cumm karke shoth kii gambhirta koo cumm curr sakata haye.
huddy key tootane kii roktham.
chlortlidone gurde dwara calcium pratidhaaran koo badhaava dekar aur seedhe austioblast vibhedan aur huddy khanij gathan koo uttejit karke khanij huddy key nuksan koo cumm kartaa haye. ack cochrane sameeksha mein iss baat key sambhaavit pramaan mille kii thiazide key sampark mein aaney seey koolhe key fracture kaa khatra cumm hoe gayaa thaa. aulhat adhyayan seey praapt aankadon key ack maadhyamik vishleshan mein paaya gayaa kii clartlidone ney koolhe aur shroni key fracture key jokhim koo cumm curr diyaa.
gurde kii pathri kii roktham.
chlortlidone mootra mein utsarjit calcium kii matra koo cumm kartaa haye, jisase calcium oxlet gurde kii pathri kaa khatra cumm hoe jaataa haye. jinn logon mein calcium oxlet gurde kii pathri key kaee episode hue hain, unamen clartlidone gurde kii pathri key ack aur episode honey key jokhim koo cumm kartaa haye. chlortlidone mootra mein calcium key star koo cumm karane key liye hydrochlorothiagide kii tulanaa mein adhik prabhaavi haye aur isaliye shayed adhik prabhaavi haye.
manier roga.
chlortlidone aayatan koo cumm kartaa haye aur iss tarah aantarik kaana kakshon mein dabaav koo cumm kartaa haye; aantarik kaana mein uchch endolymph dabaav koo menier roga yaa 'endolymphatic hydropes' kaa kaaran maanaa jaataa haye.kaee chhote, nimn-gunavatta vaale adhyayanon seey sakshya kaa sanshleshan ingit kartaa haye kii chlortlidone yaa anya thiazide mootravardhak maniers roga key liye prabhaavi hain.
madhumeh insipidus.
chlortlidone (yaa anya thiazide dawa) nephrogenic madhumeh insipidus key upchaar kaa ack pramukh ghatak haye. nephrogenic madhumeh insipidus taba hotaa haye jaba gurda kendrit mootra kaa utpaadan karane mein asamarth hotaa haye kyonki isamen renal tubeler filtrate seey mukt paani koo hataane key liye vasopressin-nirbhar aparyaapt pratikriya hoti haye. doorasth jatil nalika mein sodium aayan avashoshan koo avaruddh karke, clartlidone mootra (natruresis) mein sodium aayan key utsarjan mein vriddhi koo prerit kartaa haye. chlortlidone dene key saath-saath aahar mein sodium key sevan koo seemit karane seey halka hypovolemia (cumm intravascular matra) hotaa haye, joe sameepavarti gurde kii nully seey ghol key isotonic punah avashoshan koo prerit kartaa haye, jisase gurde key sangrah nalika aur gurde kii medulary sangrah nully mein vilayan vitaran cumm hotaa haye. sangrahit nalika aur medulary sangrah nalika mein vilayan kii yeh cumm delivery paani key avashoshan mein vriddhi aur mootra kii uchch sandrata kii anumati detee haye, joe nephrogenic madhumeh insipidus koo ack aise madhyam seey ulatati haye joe vasopressin seey swatantra haye.
pratikool prabhaav.
kuchh sameekshaon mein hydrochlorothiagide key samaan jokhim paaya gayaa haye, jabaki anya sameekshaon mein dushprabhavon kaa uchch jokhim paaya gayaa haye.
inn pratikool prabhaavon kii aavritti aur gambhirta bahut cumm hoe jaati haye jaba chlortlidone kaa upayog cumm khuraak (ee.jee., 12.5 milligram prati dinn).
kaarravaai kaa tantra.
chlortlidone mukhya roop seey gurde mein doorasth ghumaavdaar nalika koshikaon kii epical jhilli mein naa +/kla-simporter key avrodh key madhyam seey sodium aur chloride key punah avashoshan koo cumm kartaa haye. halanki chlortlidone koo aksar "thiazide-jaise" mootravardhak key roop mein sandarbhit kiya jaataa haye, yeh isamen thiazide mootravardhak key vipareet haye, isake alawa naa +/kla-simporter key isake avrodh key alawa, yeh carbonic enhydrase key kaee isophorm koo bhee dridhata seey rokta haye. chlortlidone kaa kuchh mootravardhak prabhaav bhee sameepasth nalika mein carbonic nirjalikaran key iss avrodh key kaaran hotaa haye. chlortlidone key deerghakaalik sampark mein aaney seey glomerular nispandan darr cumm hoe jaati haye. chlortlidone kaa mootravardhak prabhaav gurde kii haani vaale vyaktiyon mein cumm hoe jaataa haye. doorasth gurde kii nully mein sodium key vitaran koo badhaakar, chlortlidone apratyaksh roop seey sodium-potasium vinimay tantra (i.ee. basolateral naa +/key atpace key saath epical rome/naa channel). isake parinamswarup potasium aur chloride kii rakt sandrata cumm hoe sakati haye aur saath hii ack halka chayapachaya kshaartaa bhee hoe sakati haye; haalaanki, chlortlidone kaa mootravardhak prabhaav upchaar kiye jaa rahey vyakti key acid-bases santulan seey prabhaavit naheen hotaa haye.
chlortlidone key deerghakaalik sampark key dauran honey vaale raktchaap-cumm karane vaale prabhaav key tantra key baare mein anishchitata haye. shuru mein, mootravardhak hriday utpaadan koo cumm karke aur plasma aur baahya koshikiya drav kii matra koo cumm karke raktchaap koo cumm karate hain. antatah, hriday kaa utpaadan samanya hoe jaataa haye, aur plasma aur baahya koshikiya drav kii matra samanya seey thodi cumm hoe jaati haye, lekin paridhiya samvahani pratirodh mein kamee bunny rahati haye, jisake parinamswarup samagr roop seey cumm raktchaap hotaa haye. intravascular volume mein kamee plasma renin gatividhi aur aldosterone sraav mein vriddhi koo prerit karati haye, joe thiazide mootravardhak chikitsa seey judey potasium key nuksan mein aur yogdan detee haye.
pharmacokinetics.
maukhik antargrahan key baad chlortlidone dheere-dheere jathrantra path seey avashoshit hoe jaataa haye. iska aadhaa jeevan lamba hotaa haye aur isaliye ack lambi mootravardhak kriya hoti haye, jisake parinamswarup ack khuraak chhodane key bavjood mootravardhak prabhaav jaari rahata haye. cumm khuraak key bavjood chlortlidone kii yeh lambi kaarravaai chlortlidone kii uchch prabhavkarita key liye jimmedaar hoe sakati haye, joe kii cumm ardh-jeevan dawa, hydrochlorothiagide kii tulanaa mein adhik prabhaavi hoe sakati haye. chlortlidone koo shareer seey jyaadaatar gurde dwara aparivartit dawa key roop mein samaapt curr diyaa jaataa haye. iss prakaar, gurde key kaary mein kamee vaale vyaktiyon mein, chlortalidone kii nikasi cumm hoe jaati haye aur unmoolan aadhaa jeevan badh jaataa haye.
anya thiazide mootravardhak key saath, chlorlidone naal koo paar kartaa haye aur stun key doodh mein utsarjit hotaa haye. chlortlidone stanpan koo dabaa sakata haye, aur iss sanket key liye iska upayog kiya gayaa haye. apane lambe aadhe jeevan key kaaran, maatri vajan-samaayojit khuraak kaa kewal 6 pratishat praapt karane key bavjood, chlorlidone navjat shishuon mein stun key doodh key madhyam seey jamaa hoe sakata haye.
rasayan vigyaan.
chlortlidone sulfamoilbenzamide varg mein haye. choonki isamen thiazide-prakaar key mootravardhak kii benzotheadiazine sanrachana kaa abhaav haye, isaliye ise thiazide-jaisi mootravardhak kahaa jaataa haye. chlortlidone dimethylasitamide (dee. aim. aeye.), dimethylformide (dee. aim. aff.), dimethylsulfoxide (dee. aim. aiss. oh.) aur methanol mein swatantra roop seey ghulansheel haye; yeh germ ethanol mein bhee ghulansheel haye.
chlortlidone (inn/bain) key anusaar dawa kaa aadhikarik naam haye, joe vishva swaasthya sangathan dwara samanvit dawa namkaran pranali haye. chlorthalidone (usa) key anusaar dawa kaa aadhikarik naam haye, joe americi chikitsa sangh (aeye. aim. aeye.), sanyukt raajya aushadhi sammelan (yuu. aiss. pee.) aur americi pharmacist association (aeye. aff. aeye.) dwara saha-praayojit americi parishad dwara samanvit dawa namkaran pranali haye.
samaaj aur sanskriti.
chlortlidone koo kuchh khelon (cricket sahit) key liye pratibandhit kiya gayaa haye kyonki yeh ack mootravardhak haye, aur iska upayog shareer key vajan koo cumm karane yaa pradarshan badhaane vaali davaaon key saha-upayog koo chhipaane key liye kiya jaa sakata haye. kushti yaa mukkebaji jaise khel shareer key vajan key anusaar khilaadiyon koo vargeekrit karate hain; chlortlidone jaise mootravardhak lene seey shareer kaa vajan cumm hoe sakata haye, aur iss tarah ack khilaadi koo halke vajan vaale varg mein pratispardha karane kii anumati milati haye, joe ack laabh pradaan karega. chlortlidone jaise mootravardhak bhee mootra kii ekagrata koo cumm karate hain joe sahavarti roop seey lii gaee pradarshan badhaane vaali davaaon yaa unake chayapachaya kii matra koo cumm karate hain, iss prakaar mootra pareekshan kaa upayog karke inn davaaon kaa pataa lagaana adhik kathin hoe jaataa haye.

