Vanhu vanorarama nechirwere chisingaperi chisingagadziriswe cheplm (COPD) vanowanzomirirwa kuti bronchodilator , rudzi rwemishonga inoshandiswa kuvhara mhepo mavara kuti ikubatsire kufema zvakanaka. Iyo mishonga inowanzovharidzirwa kuburikidza nemuromo uchishandisa miviri iner inhaler (MDI) asi inowanikwawo mumvura, mapiritsi, injectable, kana suppository maitiro.
Bronchodilators inogona kushandiswa pane imwechete inenge ichidiwa kana kuti inorayirwa kaviri zuva rimwe nerimwe kudzivirira kana kuderedza zviratidzo zveCOPD . Aya mapoka matatu ebronchodilators anowanzoshandiswa kurapa COPD ndeaya:
- Beta-adrenergic agonists
- Anticholinergics
- Methylxanthines
Beta-Adrenergic Agonists
Beta-adrenergic agonists (inozivikanwawo se beta-agonists) inorudzi rwemishonga inosungirirana kune zvakagadziriswa mumapapu anonzi beta-adrenoceptors. Nokuita kudaro, vanovhara chinotyisa kumaruva emhepo uye vanobvumira migwagwa yemhepo kuti izarure.
Beta-agonists inogona kunge iri nguva pfupi-inoshanda (inopedza maawa mana kusvika matanhatu) kana nguva refu-inoshanda (inopera 12 kana kupfuura maawa). Dzinoponeswa mumuromo kana kuburikidza neMDC. Nzira yakakanganiswa inowanzosarudzwa sezvo inoderedza zviratidzo zvinokurumidza.
Bfupi-acting beta agonists (SABAs) ikozvino inogamuchirwa muUnited States ndeyikuti :
- Albuterol
- Xopenex (levalbuterol)
- Metaproterenol
- Terbutaline
Iyo yakareba-acting beta agonists (LABAs) ikozvino inogamuchirwa muUnited States ndeyi:
- Salmeterol
- Performomist (formoterol)
- Bambuterol
- Indacaterol
- Brovana (arformoterol)
Beta-agonist mishonga inoshandiswawo muviri-in-one formulations yakafanana neSymbicort iyo inosanganisira formoterol ine corticosteroid inoputika inozivikanwa sebudesonide.
Zvinodhaka zvinokonzerwa nemishonga kazhinji zvinowanikwa nehutano uye zvinowanzoonekwa nekushandisa mumuromo.
Yakawanda inosanganisira kukurumidza kwema moyo (tachycardia), kurwadziwa kwemwoyo, kudengenyeka, nekuvhiringidzika kwehope.
Anticholinergics
Anticholinergics imishonga inovhara rudzi rweurourotransmitter inozivikanwa saacetylcholine. Parasympathetic nerve (iyo inobatanidza nechinangwa chega-chinangwa) ndiyo inonyanya kunobva acetylcholine mumapapu. Nokudzivisa kushandiswa kwezvinhu izvi, zvipembenene uye zvinyorwa mumhepo inoenda zvakanaka zvakamira.
Anticholinergics inongowanikwa muhuwandu husina kuvharwa uye inopa hutano hwakanaka kwazvo nehuwandu hwemigumisiro. Anticholinergics inonyanya kukosha kune avo vasingagoni kushandisa beta-agonists kana methylxanthines nemhaka yepfungwa yepfungwa.
An anticholinergics yakagamuchirwa muUnited States ndeyi:
- Atrovent (ipratropium)
- Spiriva (tiotropium)
- Aclidinium
Iko kunewo kusanganiswa kwekugadziriswa kwakagadzirwa kunonzi Combivent ine ipratropium uye shoma-acting beta-agonist albuterol.
Nzira dzakawanda dzinowanzoitwa anticholinergic zvinodhaka dzakaoma muromo uye mushure mutsvuku. Muzviitiko zvisingawanzoitiki, glaucoma yave ichizivikanwa kuti inoitika.
Methylxanthines
Methylxanthines iboka rakasiyana-siyana remishonga inozivikanwa kuti kuderedze kuputika kwemhepo, kuderedza kuputika, uye kutsamwa kwezvipembenene.
Nzira yavo yekuita haisi kunyatsonzwisiswa, uye, kana ichishanda, zvinodhaka hazvisati zvichishandiswa mumutambo wekutanga pamusana pehuwandu hwemigumisiro.
Methylxanthine inonyanya kukodzera kune vanhu vasingakwanisi kuwana kukwana kwakakwana nemishonga ye beta-agonist kana anticholinergic. Kusiyana nedzimwe mhando dzeCOPD bronchodilator, methylxanthines haisi inhaled. Iko ikozvino inowanika mune mapiritsi, mvura, intravenous, kana suppository formulations.
Mishonga mbiri yemethylxanthine inogamuchirwa muUnited States ndeyikuti:
- Theophylline
- Aminophylline
Zvimwe zvikamu zvinogona kuitika dzimwe nguva zvingava zvakakomba, kunyanya kana zvichisunungurwa mukati.
Zviratidzo zvinogona kusanganisira misoro, kusuruvara, kushungurudza, kurarisa, kuora, kufema nokukurumidza, uye kuora mwoyo. Dana chiremba wako pakarepo kana iwe uchirutsira, kusagadzikana kwepfungwa ( dysrhythmia ), kana kuti kugumburwa.
> Kwakabva:
> Vestbo, J .; Hurd, S .; Agusti, A. et al. "Global plan yekuongorora, kutarisira, nekudzivirira zvirwere zvisingaperi zveplmmm disease: GOLD executive summary." Am J Respir Crit Care Med. 2013; 187 (4): 347-65. DOI: 10.1164 / rccm.210204-0596PP.