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Лекарственно-индуцированная гипофосфатемия

https://doi.org/10.33667/2078-5631-2021-23-79-91

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Аннотация

Гипофосфатемия (ГФ) определяется как снижение уровня неорганического фосфора в сыворотке крови ниже 2,5 мг/дл (0,81 ммоль/л). Одной из причин развития ГФ является прием ряда лекарственных средств: диуретиков, некоторых антибактериальных препаратов, инсулина, антацидов, растворов глюкозы для парентерального введения, противоопухолевых препаратов. Истинная распространенность лекарственно-индуцированной (ЛИ) ГФ неизвестна, потому что оценка уровня фосфатов не проводится рутинно, а лишь при подозрении на ГФ. Наиболее частым механизмом развития ЛИ ГФ является повышение экскреции фосфатов почками. В большинстве случаев ЛИ ГФ протекает бессимптомно и регрессирует после прекращения приема препарата-индуктора. Для восполнения фосфатного дефицита используют немедикаментозные методы (диета) и фармакотерапию. Профилактика ЛИ ГФ предполагает отказ от применения ЛС, прием которых ассоциирован с развитием ЛИ ГФ, особенно у пациентов из групп риска развития ГФ.

Об авторах

О. Д. Остроумова
ФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России
Россия

Ольга Дмитриевна Остроумова, д. м. н., проф., зав. кафедрой терапии и полиморбидной патологии

Москва



С. А. Близнюк
ГБУЗ г. Москвы «Городская клиническая больница имени С. П. Боткина Департамента здравоохранения Москвы
Россия

Светлана Александровна Близнюк, к. м. н., врач-кардиолог кардиологического отделения для больных с инфарктом миокарда № 28

Москва



А. И. Кочетков
ФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России
Россия

Алексей Иванович Кочетков,  к. м. н., доцент кафедры терапии и полиморбидной патологии

Москва



А. Г. Комарова
ГБУЗ г. Москвы «Городская клиническая больница имени С. П. Боткина Департамента здравоохранения Москвы
Россия

Анна Григорьевна Комарова, к. м. н., врач-кардиолог, зам. главного врача по региональному сосудистому центру

Москва



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Остроумова О.Д., Близнюк С.А., Кочетков А.И., Комарова А.Г. Лекарственно-индуцированная гипофосфатемия. Медицинский алфавит. 2021;(23):79-91. https://doi.org/10.33667/2078-5631-2021-23-79-91

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Ostroumova O.D., Bliznyuk S.A., Kochetkov A.I., Komarovа A.G. Drug-induced hypophosphatemia. Medical alphabet. 2021;(23):79-91. (In Russ.) https://doi.org/10.33667/2078-5631-2021-23-79-91

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