Varume vakawanda vane chirwere chemwoyo vanogona kutora sildenafil zvakachengeteka
Viagra (sildenafil) yakashandura kurapwa kwehutano hwepabonde hwevarume. Zvisinei, kushandiswa kwayo kwakanzi kune ngozi kune varwere vane mamwe marudzi ehutano hwemoyo. Chinangwa chechinyorwa chino ndechekuongororazve kushandiswa kwakachengeteka kweSildenafil mune varume vane chirwere chemoyo.
Migumisiro Yechipfuva Yokutora Sildenafil Ane Mwoyo Dendaase
Sildenafil ine zviito zviviri zvinogona kunge zvakaguma kune varwere vane chirwere chemwoyo.
Chokutanga, inogona kuderedza ropa. Chechipiri, inobatanidza ne nitrates.
Sildenafil is a vasodilator (kureva, chirwere chinoderedza midziyo yeropa ), uye naizvozvo, inoderedza systolic yeropa (iyo "inopera" nhamba mumutsara wekuyerera kweropa) nereji ye 8 mmHg. Muzhinji rwevarwere vane chirwere chemwoyo, kusanganisira vazhinji veavo vanorapwa nemishonga inorwisa antihypertensive, iyi haisi dambudziko. Zvidzidzo zvakaratidza kuti kuitika kwemigumisiro yakaipa (kusanganisira migumisiro yechirwere yakakonzerwa nekuderera kweropa, zvakadai sechezzinesi uye kupera simba) haisi yakanyanya muvashandi veSildenafil avo vari kutorawo antihypertensive drugs.
Zvisinei, zvinokonzera vasodilating zveSildenafil zvinogona kuva zvinokuvadza kana zvichisanganiswa nemigumisiro yevasodilating ye nitrate, zvinodhaka izvo zvinowanzoshandiswa kune varwere vane chirwere chetachiona. Varwere vanotora zvose nitrate naSalenafil vanowanzova nehana yakasimba ( yakaderera ropa ) uye syncope (kuneta.) Varwere vanotora nitrates nokuda kwehutano hwavo hwegoni, saka, havafaniri kutora sildenafil.
Uyezve, ani zvake akatora sildenafil mumaawa makumi maviri akapfuura haafaniri kutora nitrates.
Apo sildenafil yakatanga kubudiswa mukati mekupera kwema1990, nhoroondo dzekurwisa kwemoyo uye kufa kamwe kamwe mushure mekutora mushonga uyu kwakaonekwa kwose kwose kwemashoko. Zvimwe zvidzidzo zvakaratidza kuti, kune varwere vasingatori nitrate , kushandisa sildenafil muvarwere vane hutano hwakasimba huri hutachiona hunoita kuti kuwedzerwa kungozi yekurwadziwa kwemoyo kana kufa.
Kunyange zvazvo zviitiko izvi chaizvoizvo zvichiitika kune varwere vane chirwere chegoni, chirwere chavo hachisi chakanyanya kune varwere vanotora sildenafil.
Zvechokwadi, sildenafil inoratidzika kuti yakanyatsorambidzwa muvarume vane hutano hwakanyanya hutachiona hwehutano, chero bedzi vasina kushandisa ischemia (nguva dzenguva iyo musimba wemwoyo uri kuwana kuwana kukodzera kweropa, kakawanda inoratidzirwa nemarwadzo emapfupa ) uye havatori nitrates. Uyezve, sildenafil haina kuwedzera mukana wekurovedza muviri kune varwere vane hutano hwakasimba hwehutano hutano.
Pane mimwe mitemo umo kuderera kunononoka mu systolic ropa rinokonzerwa naSildenafil kunogona kuva nengozi. Varwere vane kukanganisa kwakanyanya kwemoyo pamwe chete nekuderera kwemiganho yeropa kunogona kuipa kana mamwe hypotension achibudiswa. Mukuwedzera, vamwe varwere vane hypertrophic cardiomyopathy vangava zviratidzo kana systolic yeropa ravo iri shoma.
The Bottom Line
IAmerican College of Cardiology neAmerican Heart Association vanobvuma kuti sildenafil yakachengeteka kune varume vane hukama hwakasimba hutano hutachiri husina kutora nitrates asi haufaniri kushandiswa kune varwere vari kutora nitrates. (Nitrates inosanganisira marudzi ose e nitroglycerin - zvinyorwa zvinyorwa, transdermal uye spray forms - pamwe ne isosorbide mononitrate, isosorbide dinitrate, pentaerythritol tetranitrate, erythritol tetranitrate, uye amyl nitrate.)
Izvo zvinofanira kuonekwa kuti, kunyange munguva yakapfuura nitrates yaiva nheyo yehutano hwehutachiona hwehutano, izvi hazvisati zviri izvo. Munguva yemazinga e- angioplasty uye inotyisa, chirwere chegoni chinowanzogadziriswa pasina kushandisa nitrates. Varwere vari kunyorwa nevatrates uye vanoda kufara sildenafil vanofanira kukumbira vanachiremba nezvemamwe maitiro erapi nokuda kwehutano hwavo hwehutano.
Kune mamwe mapoka evarwere vemwoyo avo sildenafil inogona kunge inogona kuva nengozi. Izvi zvinosanganisira varwere vane hutano husina kugadzikana rwehutano hwehutano kana hutano hunoita hutachiona ischemia (kureva, varwere vane chirwere chemapurisa chinogadziriswa hachina kugadzikana.) Varwere ava, zviri pachena, vane chirwere chakasimba chekurapa chinoda kugadziriswa kana sildenafil ichiri kutorwa kana kuti kwete.
Kamwe chete kana vakagadzirirwa zvakakwana, kushandiswa kweSildenafil (pamwe chete nemamwe marudzi ose ehupenyu, hupenyu hwezuva nezuva hwakadai sekurovedza muviri) kunogona kufarirwa.
Vamwe varwere vanogona kunge vane dambudziko reSildenafil ndevaya vane mwoyo wekukundikana pamwe chete nemiganhu yakaderera ropa , vamwe varwere vane hypertrophic cardiomyopathy, uye zvichida, varwere vane zvinodhaka zvinodhaka zvinokonzerwa nehutachiona.
Nezvo izvi zvisiri izvo, sildenafil inogona kushandiswa zvakachengeteka muhuwandu hwevarwere vane chirwere chemoyo.
Sources:
Kostis JB, Jackson G, Rosen R, et al. Kushushikana kwepabonde uye ngozi yemwoyo (yeChishanu yePrinceton Consensus Conference). Am J Cardiol 2005; 96: 313.