Calcium channel blockers iboka guru remishonga inoshandiswa mukurapa matambudziko akawanda emwoyo kunosanganisira angina , hypertension , supraventricular tachycardia , uye hypertrophic cardiomyopathy .
Overview
Calcium channel blockers inodzivisa calcium kuti isapinda mukati memwoyo masero masero, uye mumasero mashoma anokonzera mitsipa yeropa.
Nokuderedza calcium inowedzera, calcium channel blockers inokonzera kuti masero masero "asunungure." Izvi zvinokonzera kugadzirisa zvinokonzera kuputika kwemidziyo yeropa, uye simba rakaderedzwa rekudzivirira kwemutsipa wemwoyo.
Dzimwe calcium channel blockers dzinotadzisawo nhengo ye sinus uye chiyero apo inzwi remagetsi inonzwa inopfuurira kuburikidza neNode yeAV . Izvi zvinogadzira calcium blockers inobatsira mukurapa mamwe arrhythmias .
Zvose zvinokonzerwa ne calcium blockers (ropa mudziyo kuwedzera, kuderedzwa kwemwoyo musungo kumeso, uye kunonoka kwepfungwa yemwoyo) kunoderedza kuwanda kwe okisijeni inodiwa nemutsipa wemwoyo.
Kuderedza kuwanda kwemhepo inoshandiswa nemwoyo kunobvumira mwoyo kushanda kwenguva refu pasina kuwedzera ischemia , kunyange kana ropa richiyerera mukati me coronary arteries inenge yakadzivirirwa nea atherosclerotic plaque . Mune varwere vane angina akachengetedza , calcium blockers kazhinji vanowedzera huwandu hwemashonga anokwanisa kuitwa asati angina yakaitika.
Calcium blockers inogona kunyanya kubatsira kune varwere vane Prinzmetal's angina (coronary artery spasm) sezvo vanogona kudzivirira zvakananga spasm yeeronary arteries.
Aina
Kazhinji kaccium blockers iri pamusika, uye haasi ose akafanana. Kune mhando mitatu yekushandiswa zvakanyanya calcium blockers:
1) Dihydropyradines .
Mishonga iyi nifedipine (Procardia, Adalat), nicardipine (Cardene), felodipine (Plendil), uye amlodipine (Norvasc), inonzi dihydropyridines. Iyi mishonga inokonzera kuwedzera kukuru kwemidziyo yeropa uye zvishoma zvingaita pamwoyo wemusana uye kutengesa mwoyo. Iyo inonyanya kukosha pakurapa chirwere chepemhetura.
2) Verapamil. Verapamil (Calan, Covera, Isoptin, Verelan) inokanganisa mutsara wemwoyo uye inonyanya kubudirira mukudzikisa kutengesa kwemoyo, asi ine zvishoma pamiganho yeropa. Hazvibatsiri zvikuru kune hutachiona hwepamusoro asi zvakanyatsonaka kune angina uye cardiac arrhythmias.
3) Diltiazem. Diltiazem (Cardizem, Dilacor, Tiazac) ine zvinyanyisa zvinokonzera pamisvo yemwoyo uye nemidziyo yeropa. Iko kunowedzera kubvumira zviri nani kudarika mamwe akawanda e-calcium blockers
Ushumiri
Kurapa kwaAngina
Vose calcium blockers vave vachishandiswa kurapa angina. Zvisinei, iyo inowanzoshandiswa kanamicum blockers ndiyo yakareba-inobata maitiro e diltiazem uye verapamil, amlodipine, kana felodipine.
Nifedipine, kunyanya maitiro ayo maduku, inofanira kudzivirirwa mune varwere vane angina, sezvo iyo inonzi ropa yemvura inoputika inobudiswa nemushonga uyu inogona kuwedzera mu adrenaline, zvichiita kuti mwoyo uwedzere kukurumidza, uye zvichidaro kuwedzerwa kwemhepo inokonzera oksijeni ( iyo inogona kuwedzera mikana yekuvandudza mwoyo ischemia).
Nenzira yakawanda, nepo calcium blockers inobatsira pakusunungura angina, inofungidzirwa kuva yakaderera kune beta blockers . Nhasi mazano ndeokuti:
- Calcium blockers inofanira kuidzwa muvarwere vasingakwanisi kubvumira beta blockers.
- Calcium blockers inofanira kuwedzerwa kune beta blockers kune varwere vasina kukwana kwakakwana kwezviratidzo ne beta blockers.
Mamwe Maitiro Anowanzoitwa
- Hypertension. Iyo dihydropyradine calcium blockers inobatsira zvikuru mukurapa huwandu hwehutano, uye inowanzoshandiswa seyendo yekutanga yekurapa kweStage I yeupupuriro. Verenga pamusoro pokusarudza "zvakanaka" zvinodhaka zvehutano.
- Supraventricular arrhythmias. Calcium blockers (kunyanya verapamil) inowanzovhara basa reAV node, uye naizvozvo inowanzobatsira mukurapa zvinyorwa zvinyorwa zvinotenderera pane node yeVV kuitira kuti irambe ichienderera mberi. Kunyanya, AV nodal reentrant tachycardia (iyo inowanzozivikanwa yepamusoro-soro yechiramthmia) inogona kutongororwa nerapa verapamil.
- Hypertrophic cardiomyopathy. Calcium blockers inogona kushandiswa kubatsira kuderedza "kusuruvara" kwerutivi rworuboshwe kune vanhu vane hypertrophic cardiomyopathy, uye nenzira iyi inogona kuderedza zviratidzo.
Migumisiro Yechiri
Kazhinji migumisiro ye calcium channel blockers inosanganisira misoro, chizivi, kuputika, uye tsoka uye kuvukurwa kwechikwama. Verapamil, kunyanya, inowanzoita kuti kubatwa.
Nemhaka yokuti calcium blockers inowanzoita kuti kuderedzwa simba rekusimbiswa kwemutsipa wemwoyo, inofanira kushandiswa nekuchenjerera (kana zvachose) kune varwere vane mwoyo usina kukwana .
Zvinowanzoita kuti usapinda verapamil uye diltiazem kune vanhu vane bradycardia sezvo izvi zvinodhaka zvicharamba zvishoma nezvishoma.
> Sources:
> Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF / AHA Nhungamiro yeKutsvaga uye Kurapwa kweHypertrophic Cardiomyopathy: Dare Summary: Mharidzo yeAmerican College of Cardiology Foundation / American Heart Association Task Force pamusoro Pemitemo Yezvokuita. Kurwisana 2011; 124: 2761.
> Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF / AHA / ACP / AATS / PCNA / SCAI / STS Nhungamiro yeKutsvaga uye Kutungamira kweVatano vane Stable Ischemic Heart Disease: Bhuku reAmerican College of Cardiology Foundation / American Heart Association basa rekuita mitemo, uye American College ya Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, uye Society of Thoracic Surgeons. Circulation 2012; 126: e354.
> Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH / ESC Zvinyorwa zvekutungamirirwa kweArterial Hypertension: Basa reKubata kweArterial Hypertension yeEuropean Society of Hypertension (ESH) uye yeEuropean Society of Cardiology (ESC). J Hypertens 2013; 31: 1281.