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Urinary System Lithiasis – Pharmaceutical Treatment
Urinary System Lithiasis – Pharmaceutical Treatment
1. Cystine Stones
In these cases it is recommended that ample fluid intake (> 2lt/24h) and urine alkalinization to pH 8, since cystine are soluble in urine of patients with alkali. Particular emphasis should be given to the fact that patients are required to consume liquid and during the night after the urine is then more concentrated and increases the likelihood of stone formation. The d-penicillamine is a substance which in 2gr/24h dose is very effective since it has the capacity to bond with cystine and converts it to soluble substance.
2. Uric acid stones
The mainstay of treatment in these patients is hydration (> 2000cc per day), urine alkalinization (urinary retention Ph 6,5-7,0) which is induced by administration of bicarbonate (soda or better yet potassium citrate), the use of allopurinol (100-300 mg/24h) and the diet which is based on deprivation purines.
3. Oxalate Stones
In this patient group, a significant role is played by increased fluid intake, diet with restriction of oxalates, limiting salt intake and fat and increase fiber intake. The substances are administered pyridoxine (vitamin B6) which inhibits the synthesis of oxalates and phosphates.