Amiodarone

Zvimwe zvakakosha, asi zvinongonyanya kutyisa

Amiodarone (Cordarone, Pacerone) ndiyo inonyanya kushanda, uye zvechokwadi inoshamisa, antiarrhythmic drug yakambotangwa. Kana chiremba wako achida iwe kutora ichi chirwere nokuda kwechirwere chemwoyo , unoda kunzwisisa idiosyncrasies - uye njodzi-inobatanidza nayo.

• Verenga pamusoro pemishonga inorwisa mishonga.

Zvimwe Zvisingaoneki zveAmiodarone

Amiodarone ine zviitiko zvakasiyana siyana zvinoita kuti zvive zvakasiyana pakati pemishonga inorwisa-uye kunyange pakati pemishonga inowanzo.

Kutanga, kana kutorwa nemuromo, amiodarone inotora mavhiki kuti ibudirire kubudirira kwayo, uye nokuda kwechikonzero chisingawanzoitiki. Kunyange zvazvo mishonga yakawanda inopararira muropa remvura kwechinguva kusvikira ichigadziriswa kana kuti yakanyanyiswa, amiodarone inochengetwa mumatumbu emuviri. Zvose zvinokonzerwa nehutachiona hwemishonga hazvikwanisi kusvika kusvikira mishonga yakakwana zvakakwana yakazara nemadiodarone. Saka mishonga inofanirwa "kutakurwa" isati yava yakanyatsoshanda. Chimiro chekuti "kutakura" regimen yeAmododarone inenge iri yekushandisa mikuru yakawanda yemuromo kwevhiki kana maviri, uye tapira muyero pamwedzi unotevera kana zvakadaro. Hazvisi zvisizvo kupa vanhu 1200 kana 1600 mg pazuva pakutanga, uyezve, pakupedzisira, kuchengetedza ivo vashoma kana zana kana 200 mg pazuva (mumuromo).

Amiodarone zvakare inokwanisa kutarisirwa mukati-kati kana kurapa chirongwa chekugadzirira chiitiko chinokurumidza, uye chiitiko chacho chinonyanya kukurumidza nenzira iyi. Zvisinei, kushanduka kubva pamwoyo kusvika pamuromo inofanira kuitwa zvakanyatsonaka, sezvo kwekusingaperi kushandiswa kwechirwere ichi chichiri "kutakurwa" kwenguva yakareba.

Chechipiri, amiodarone inobva mumuviri, zvishoma nezvishoma. Hazvisi zvinyararire kune chiyero chinoyevedza neechiropa kana itsvo. (Amiodarone inoshandiswa mune chiropa kusvika kune desethylamiodarone, iyo ine simba rimwechete reararhythmic uye chechivheneko seamidodarone, uye iro rinoramba riri mumuviri kwenguva yakareba.) Pamusoro pazvo, amiodarone uye metabolites yayo inobviswa mumuviri kana Amaododarone-containing cells akarashika - akadai semasero eganda, kana masero kubva pamatumbo emimba, ayo anodonhedzwa nemamiriyoni zuva rega rega.

Izvi, zviri pachena, ndezvenguva refu, inononoka.

Nokudaro, kana zvakatemwa kuti zvakakosha kumisa amiodarone (nemhaka yemigumisiro, somuenzaniso) mushonga unoramba uri mumuviri muhuwandu hunogona kuenzaniswa kwenguva yakareba mushure mekunge muroti wekupedzisira watorwa. I "hafu yeupenyu" yeAmododarone, kusiyana nemamwe mishonga yakawanda, inotarwa mumavhiki panzvimbo maawa.

Chechitatu, nokuti amiodarone inochengetwa mumatumbu akawanda akasiyana mukati memuviri, inogona kubudisa migumisiro yakaipa inobata nhengo dzakawanda dzakasiyana. Mimwe yemigumisiro iyi inogona kutora mwedzi kana makore kuti ibude, saka ani naani anotora ichi chirwere anofanira kugara akangwarira mitsva miviri.

Chechina, amiodarone inoshanda nenzira dzakasiyana-siyana, kusiyana nemishonga yakawanda. Iyo inopinda mumapoka maviri akasiyana emishonga inopesana nemasikirwo (Chikoro I neChikamu III, pane zvakakosha). Inoshanda se beta blocker uyewo se calcium blocker . Inoderedza midziyo yeropa, uye inowanzoita "kudzivisa" zvinoitwa nehomoni yekemikari. Zvose izvi zvinokonzera kukwanisa kwayo kugadzirisa arrhythmias, uye zvichida nhoroondo yebudiriro ya amiodarone yakasiyana.

Zvimwe Zvikamu zveAmiodarone

Izvozvo zvinokonzerwa neAmaiodarone kazhinji dzinotora mavhiki kana mwedzi (kana kunyange makore) kukura, saka ani naani anotora ichi chirwere anofanira kungwarira chero bedzi mushonga uri kushandiswa.

Uyezve, migumisiro yemasodarone inowanzova isina kujairika pamishonga inorwisa-kana chero yemishonga chero ipi zvayo. Nokuda kwezvikonzero izvi, apo amiodarone akatanga kupinda muchipatara kushandisa zvakatora makore anopfuura makumi maviri kuti vanachiremba vaone kuti vazhinji vezviratidzo zvisingaoneki zvavakanga vachiona zvaive zvichikonzerwa nemadiodarone. Kusvikira nhasi, vanachiremba vose vanowanzokundikana kutarisa varwere vavo vachitora amiodarone kwenguva yakakwana, uye nekushingaira zvakakwana, kuziva kuti mushonga uri kuunza matambudziko.

• Verenga nhoroondo isinganzwisisi ye amiodarone .

Heano mamwe emamwe matambudziko anokwanisa kuonekwa ne amiodarone:

• Amiodarone kazhinji inokonzera mari yekuumba pamakona emaziso, kazhinji kutungamirira ku "halo-maonero," apo kutarisa zviedza zvinopenya usiku hunoita kutarisa mwedzi pane manheru emvura.
• Amiodarone inogona kukonzera kuora mwoyo (uye zvichida kusingaperi) bhuru-grey discoloration yeganda, kazhinji munzvimbo dzezuva.
• Amiodarone kazhinji inokurudzira ganda kuvhenekera, kuitira kuti kunyange kusvibiswa kuduku kunogona kukonzera kupisa kwezuva kusina kunaka.
• Amiodarone inogona kukonzera zvinetso zvehutano, zvose hypothyroidism (yakaderera utachiona) uye hyperthyroidism (yakakwirira yehutachiona.) Matambudziko aya ehutachiona akajairika neamayodarone, uye anogona kunge asina kuoma kunzwisisa nekubata. Nokuda kwechikonzero ichi, varwere vanotora mishonga iyi vanofanira kunge vane utachiona hwavo hunowanzotariswa. Verenga zvakawanda nezvemamodarone uye utachiona.
• Amiodarone inogona kukonzera chiropa chekutyisa, saka enzymes yeropa inofanira kuongororwa nguva nenguva.
• Amiodarone inogona kukonzera maitiro akaoma asi acid reflux disorder .
• Iyo yakavhiringidzika yechirongwa chemadiodarone chirwere chemapapu. Izvi zvinogona kutora mhando dzakasiyana. Inogona kutora maitiro eAacute lung syndrome inokonzera kuti varwere vanorwara zvakanyanya, inoda kutarisira kwakasimba, uye kazhinji inoguma murufu. Kana kuti, zvinogona kukonzera kusanyengedzera, zvishoma nezvishoma, zvisingazivikanwi, "kuoma" kwemapapu ayo zvose chiremba uye murwere vanogona kutarisa kusvikira zvakanyanya, zvichida kusakanganiswa kwemapapu asina kukanganisika kwaitwa. Verenga zvakanyanya nezve amiodarone lung toxicity.

Amiodarone Inofanira Kuitwa Rini?

Nemhaka yezvinetso zvakasiyana-siyana uye njodzi dzekushandisa amiodarone, ichi chinodhaka chinofanira kushandiswa chete kune vanhu vane magirthmias ari kutyisa upenyu kana kukanganisa zvikuru kuhupenyu, uye chete kana pasina imwe nzira ine mazano ekurapa. Pasinei nezvipingamupinyi zvaro, zvakadaro, amiodarone zvechokwadi inoshanda zvakakosha, uye yakabatsira kudzorera zviuru zvevanhu vanorega kugadzirisa arrhythmias kune hupenyu hunenge huri pasi.

Shoko Rinobva

Kana yakashandiswa zvakakodzera, amiodarone inogona kuva yakakosha zvikuru kune vanhu vane chirwere chakakomba chinonzi cardiac arrhythmias. Asi nekuda kwekugona kwayo kutyisa, kushandiswa kwayo kunofanira kunge kusingagumi. Cheropi chiremba anonyora kuti amiodarone inokwereta murwere wake kunyatsokurukurirana nezvezvinetso zvakawanda zvinogona kuitika nemishonga, uye inofanira kuzvipira kuva mukana wenguva refu wemurwere wavo, kunyatsotarisa nezvemigumisiro mitsva, chero bedzi iyi mishonga yakasiyana-siyana iri kushandiswa.

> Sources:

> Goldschlager N, Epstein AE, Naccarelli GV, et al. Bhuku rinoshanda reKliniki Inobata Vatano NeAmiodarone: 2007. Heart Rhythm 2007; 4: 1250.

> Vassallo P, Trohman RG. Kunyora Amiodarone: IEvidence-Based Review yeKliniki Zviratidzo. JAMA 2007; 298: 1312.