"I-Finoptin": imiyalelo yokusetyenziswa, ukubunjwa, ubungqina, izifaniso

Abantu abaninzi banezifo zentliziyo kunye nemithambo yegazi. Ukongezelela, xa uneminyaka yobudala, umngcipheko weemeko ezinjalo zentsholongwane ukwandisa kakhulu. Ukunciphisa amathuba okuphuhlisa iinkqubo ezinzulu emzimbeni, oogqirha bancomela ukusebenzisa iindlela ezizodwa. Phakathi kwabo, i- calcium channel blockers iyakuthandwa kakhulu . Baye kwiqela eliphilileyo lamayeza. Indlela yabo yesenzo ihambelana nokukwazi ukuvimbela ukungena kwe-Ca ions kwi-intercellular space kwiiseli zeempahla kunye nentliziyo. Ukunciphisa uxinzelelo lwale miba, isichengisi sinomphumo we-vasodilating.

Isiza esona sisebenzisekayo sinezi propati "i-Finoptin". Izikhokelo zokusetyenziswa, ukubunjwa, iingu-analogs, izibonakaliso zokusetyenziswa kweziyobisi kunye neziphumo zaso zichazwe ngezantsi.

Ifom, ukubunjwa

Yiyiphi ifom eqhelekileyo kwiyeza "Finoptin"? Imiyalelo yokusetyenziswa ithetha ukuba ithengwa ngendlela yesisombululo kunye nesipilisi.

Njengoko isithako esisebenzayo sale nkunkuma yi-verapamil hydrochloride. Kwakhona, ukubunjwa kwesilwanyana kubandakanya iindidi ezincedisayo (kuxhomekeke kwindlela yokukhululwa).

I-Pharmacological action

Ziziphi iimpawu ezihambelana nokulungiselela "Finoptin"? Imiyalelo yokusetyenziswa, ukuphononongwa kuthiwa yi-blocker ye-calcium ye-blocker (ekhethiweyo) kwiklasi yokuqala. Ingumthombo we-diphenylalkylamine, kwaye ibonisa kwakhona i-antianginal, antihypertensive and antiarrhym action.

Umphumo we-antianginal walesi sidakamizwa uhambelana nokukwazi kwawo ukuphazamisa i-myocardium ne-peripheral hemodynamics. Ngamanye amazwi, eli liyeza linciphisa ithoni yeerriji. Ukongeza, kunciphisa ukuguqulwa kwamandla e-ATP, ehlanganiswe kwizibophelelo ezinzulu, kumsebenzi womatshini kunye negalelo ekunciphiseni ukuthengiswa kwemvumelwano ye-myocardial.

Kufuneka kwakhona kuqaphele ukuba ukusetyenziswa kwesi sigxina kunciphisa kakhulu imfuno ye-myocardium e-O2, kwaye nayo ine-chrono-, inotropic kunye ne-vasodilating effect.

Iipropati zokulungiselela

Ngenxa yokubunjwa kwayo, iyeza "I-Finoptin", ezifana nezo zidweliswe ngezantsi, ukuphazamisa ukuzenzekelayo kwe-node yesusus, kunciphisa ukuqhutyelwa kwe-AV kwaye kwandisa ixesha lokungabikho.

Ukwandisa ixesha lokuphumla kwe-diastolic ye-ventricle (ngasekhohlo), le nkunkuma inciphisa kakhulu ithoni yeendonga ze-myocardium, oko kukuthi, isisitorelo esincedisayo kunyango lwe-hypertrophic cardiomyopathy.

Kufuneka kwakhona kuqatshelwe ukuba izidakamizwa ezikulo mbuzo zibonakalisa iimpawu ezichasene nezicwangciso ze-arhythmias.

Kinetics zonyango

Isilwanyana "Finoptin", umyalelo ochazwe ngezantsi, uxhaswa kwi-digestive tract (malunga ne-90% yesithathi esithathiweyo). Ukuqhagamshelana kwayo kunye namaprotini ngama 90%.

Isilwanyana sisetyenziswe ngexesha lokubhala (kuqala) ngesibindi. Oku kuvelisa i-derivative efana ne-norverapamil, enomsebenzi ongaphantsi kwe-hypotensive kune-verapamil engatshintshiyo.

Isiqingatha sobomi besilwanyana esinomlinganiselo owodwa ngamahora e-3-8. Xa usebenzisa amayeza aphindaphindiweyo, eli lathisi liyahluka (iiyure ezingama-5 ukuya ku-12).

Iziyobisi zinikezwa ngamathumbu kunye nezintso.

Iinkcazo

Kwiimeko zini na iyeza elithi "Finoptin" elimiselweyo? Imiyalelo yokusetyenziswa (iipilisi kunye neenjini zineendlela ezifanayo) zichaza ukuba le ndlela ingasetyenziselwa i -tachycardia engaphezulu (kuquka i-paroxysmal, i-Laun-ganong-levin syndrome kunye ne-WPW syndrome), i-angina I-Angiospasm, i-vasospastic ezinzile), i-sinus tachycardia, i-stutter flutter, i-ciliary tachyarrhythmia, i-extrasystole ye-arrivol, ingxaki yokuxinzelela emzimbeni (ukwenzela ukulawulwa kwegazi), ingozi yomshukela ophezulu, i-high blood pressure kwisitya esincinci ejikelezayo, hypertrophic cardiomyopathy obstructive.

Ukungqinelana

Ngaliphi na ixesha akufanele ubeke iyeza "Finoptin"? Imiyalelo yokusetyenziswa (iinjenge kunye neepilisi zinokuphikisana okufanayo) kubonisa ukuba le nkunkuma ayinqatshelwe ukusetyenziswa kwi-hypotension enkulu, i-Sinoatrial blockade kunye ne-SSSU (ngaphandle kwezigulane ezine-pacemaker), ukukhutshwa kwe-AV kwinqanaba lesithathu nelesibini, i-Laune syndrome -Ganong-Levin kunye ne-WPW-syndrome ngokudibanisa ne-frilling orrift (ngaphandle kwabantu abagulayo abane-pacemaker), ukukhulelwa, ukuxhomekeka kwe-verapamil, ukuncelisa.

Ukulungiselela "Finoptin": imiyalelo yokusetyenziswa

Umyinge walesi sidakamizwa ubalwa ngugqirha ngabanye.

Kwizigulane zabantu abadala, iipilisi zinikezwa ngomlomo kwisilinganiso sokuqala sama-40-80 mg kathathu ngosuku. Iifom zeesayidi kunye nezenzo ezide, kufuneka kube neyunithi enye kunye nokwenziwa kwexesha lokulawula.

Iintsana ezineminyaka engama-6 ukuya kwe-14, le nyanga iyacetyiswa ukuba ithathe umthamo wama-80-360 mg ngosuku, ukuya kwiminyaka eyi-6-kwisantya se-40-60 mg ngosuku. Ixesha eliqhelekileyo lokuthabatha eli nyanga liphindwe kane ngosuku.

Ukuba kuyimfuneko, isiza esicatshulwayo singasilwa nge-intravenously (kancane). Ngaloo ndlela kuyimfuneko ukulawula i-electrocardiogram, uxinzelelo lwentsimbi kunye nesantya senhliziyo yesigulane.

Isisombululo esisodwa esisodwa kubantu abadala si-5-10 mg. Ukuba isiphumo sokwelapha asikho, emva kwemizuzu engama-20 le nkunkuma ingafakwa kwakhona (kwimizuzu efanayo).

Ifayili enye yefayili yezilwanyana kubantwana abaneminyaka engama-6 ukuya kwe-14 kuya kweyesi-2.5 ukuya ku-5,5 mg, kubantwana abaneminyaka emi-1-5 ukuya kwi-2-3 mg, kunye nomntwana ukuya kunyaka-0.75-2 mg.

Izigulane ezinokuphazanyiswa okukhulu kwesibindi kwansuku zonke akufanele zibe ngaphezu kwe-120 mg.

Umlinganiselo ophezulu wokulungiswa ngomlomo ngosuku ngu 480 mg.

Iziphumo eziPhakathi

Isilwayo "i-Finoptin" sinokubangela ukubonakala kwezi mpawu ezilandelayo:

• Ukunyusa ubunzima, i-bradycardia, i-agranulocytosis, i-aggravation okanye ukuphuhliswa kwesifo senhliziyo, i-hyperprolactinaemia, i-tachycardia, ukulahleka kombono kwangaphambili, i-edema yeditha;
• Ukubhengezwa kwehla kumxinzelelo wegazi, i-gynecomastia, i-galactorrhea, i-arthritis, i-angina pectoris, i-arrhythmia, i -edema ye-pulmatic, i- AV-blockade yesigaba sesithathu, i-asystole, i-thrombocytopenia isymptomatic, i-collapse;
• Ukukhathazeka, ukuqina kwezandla okanye iinyawo, i-gingival hyperplasia, ukuphelelwa amandla, ukhathala okwandayo, ukwanda kwondlo, ukuxhalaba, ukwanda komsebenzi we-transaminases yesibindi;
• Ukugqithisa isikhumba, ukuxakeka, ukuzithiba okanye uhudo, intloko, ukuxinezeleka, ukuphazamiseka, ukuphazamiseka kwe-extrapyramidal, i-asthenia, i-hyphenia yesikhumba, ukulala, i-erythema multiform exudative, ukucheka.

Ukusebenzisana kwezidakamizwa

Ngaba ndingakwazi ukudibanisa iyeza elithi "Finoptin" namanye amayeza? Imiyalelo yokusetyenziswa ithi ukudibanisa kwesi sidakamizwa kunye nezidakamizwa ezichasene nezidakamizwa ziqinisa ngakumbi umphumo wazo olwabiwo.

Ngokulawulwa kwe-verapamil kubantu abanesandul 'ukufumana umthamo we-beta-blockers, kukho umngcipheko ophezulu wokuphuhlisa i-hypotension (arterial) kunye ne-asystole.

Ngolawulo oludibeneyo lweziyobisi "i-Finoptin" kunye ne-beta-blockers, iziyobisi zokuphuza i-anesthesia kunye nezidakamizwa ezichaseneyo, umngcipheko wokwenza intliziyo ingaphumeleli, i-bradycardia, i-hypotension eyingozi kunye ne-AV blockade yanda.

Ngaphandle kokufumana i-Amiodarone, i-bradycardia, in action ye-inotropic, ukukhutshwa kwe-AV kunye nokuphazamiseka kokuqhubela phambili.

Ngenxa yokuba i-verapamil inqanda i-isoenzyme ye-CYP3A4 echaphazelekayo kwi-metabolism ye-simvastatin, i-lovastatin kunye ne-atorvastatin, kukho ukubonakaliswa kokubambisana okunokwenzeka ukuba kubangelwa ukwanda kweengxowankulu kwigazi. Kukho neemeko ze-rhabdomyolysis.

Xa idibene ne-nitrate, iipropati ze-antianginal ze-"Finoptina" zanda.

Ngokulawulwa kwangexesha elifanayo le-acetylsalicylic acid, ixesha lokuphuma kwegazi liyakwanda ngenxa yempembelelo eyongeziweyo ye-antigregregant.

Ngaba ndiyakwazi ukuthatha "iDizopiramid" ngokubambisana neziyobisi "Finoptin"? Umyalelo wokusetyenziswa uyazisa ukuba indibaniselwano enokubangela ukuba i-hypotension enamandla kunye nokuwa, ngokukodwa kubantu abanokuphelelwa yintliziyo ephazamisekile okanye ukukhubazeka kwenhliziyo.

Ngokusetyenziswa kwamanye amapilisi ngexesha elifanayo kunye nesisombululo nge "Imipramine", ukugxininiswa kwegazi kwenyuka, ngenxa yoko kukho umngcipheko weenguqu ezingathandekiyo kwi-ECG. Kufuneka kwakhona kuqatshelwe ukuba i-verapamil yandisa ukuhlaselwa kwe-"Imipramine", ukunciphisa imvume yayo.

Xa isilwanyana sidibaniswe ne "Carbamazepine", umphumo wolu hlobo luya kwanda, kwaye umngcipheko weempembelelo ezivela kwi-CNS iyanda.

Ngokulawulwa ngokufanayo kwilisi kunye ne "Clonidine" kukho iimeko zokubanjelwa kwentliziyo kubantu abaneengcinezelo zengcinezelo.

Xa udibanisa iyeza kunye ne-lithium carbonate, ukubonakaliswa kokusebenzisana kwezidakamizwa akunakulinganiswa kwaye akukho ngqiqo. Kukho iingxaki ze-neurotoxicity, bradycardia enamandla, kwandiswe imiphumo ye-lithium kunye nokunciphisa ukugxininiswa kwegazi.

I-Rifampicin ichaphazela njani i-Finoptin? Umyalelo uxela ukuba inxulumano enjalo inciphisa umsebenzi we-enzyme ye-hepatic, ukukhawuleza imetabolism ye-verapamil. Ekugqibeleni, oku kukhokelela ekunciphiseni ukusebenza kwekliniki ekuthethwa ngayo.

Iingcebiso ezizodwa

Yintoni endimele ndiyazi ngaphambi kokusebenzisa iyeza "I-Finoptin" (40 mg)? Umyalelo uthi le mpendulo isetyenziswe ngokuqapha kwi-AV yokukhutshwa kwinqanaba lokuqala, i-stenosis enamandla ye-aortic aorta, i-bradycardia, i-myocardial infarction kunye nokungaphumeleli kwe-ventricular, ukungapheli kwintliziyo, ukungabikho kwengqondo engapheliyo, ukungaxhamli komzimba okanye ukungazinzi. Kwakhona, eli liyeza linconywa ngokucophelela kubantu abadala kunye nabantwana abancinci.

Kwiimeko ezinzima, kuvunyelwe ukuba kuqhutywe unyango oluhlangeneyo lwe-blood pressure kunye ne-angina ngokusebenzisa i-verapamil kunye ne-beta-adrenoblockers. Nangona kunjalo, kuyimfuneko ukuphepha ukulawulwa kwamanzi okugqibela.

Emva kokuthabatha eli gciwane, isigulane sinokuba nesimo sengqondo sokulala nokulala, okuchaphazela amandla omntu ukwenza imisebenzi eyingozi.

Ukungqinelana nokukhulelwa

Ngaba kunokwenzeka ukuba kubekwe isilwanyana "Finoptin" kwabasetyhini abakhulelweyo? Imiyalelo yokusetyenziswa ngexesha lokukhulelwa ithi le nkunkuma inefuthe elibi kuphuhliso lomntwana. Ikwa kungena kubisi lwebele. Ngoko ke, ngeemeko ezinjalo, eli chiza lichazwe ngokungqinelanayo.

Amachiza "i-Finoptin": amafanane kunye neendleko

Ixabiso le sixhobo lingahluke. Njengomthetho, kuxhomekeke kwindlela yokukhutshwa kweziyobisi, ubungakanani bayo okanye umthamo. Ixabiso eliqhelekileyo le "Finoptina" li-ruble 100-170.

Ukuba le nkunkuma iphikisana nawe, ingatshintshwa ngenye yeendlela ezilandelayo: I-Verapamil, iVeragalide, i-Verapamil-OBL, i-Kaveril, i-Verapamil i-Sopharma, i- Verapamil-LekT, i-Verapamil-Ferein, i- I-Verapamil Ratiofarm, Isoptin, i-Verapamil-Eskom, iVero-Verapamil, iVerapamil Hydrochloride kunye neLekoptin.

Iingxelo zoogqirha nabathengi

Iingcaphephe zithi iipilisi kunye nesisombululo "i-Finoptin" ziyimpumelelo kwaye zithengi ukuba zenzelwe ukubuyisela uxinzelelo lwegazi, kunye nokuphucula impilo yakho kwezinye izifo zentliziyo kunye nemithambo yegazi.

Ngokubhekisele kwizigulane, ininzi yazo iwanele ngokweenqanaba lonyango ngale ndlela. Ukufumana iipilisi okanye i-intravenous fluids kunceda ukuphelisa ngokukhawuleza iimpawu zengcinezelo yempembelelo kunye nezinye iimpawu zesifo se-cardiovascular system.

Kufuneka kwakhona kuqaphele ukuba imilayezo emibi ifumaneka ngaleliyeza. Bathetha malunga nenani elikhulu leempendulo ezimbi ezenzeka ngokukhawuleza emva kokusebenzisa iyeza. Kwakhona, abaninzi abathengi bayakhalaza malunga nokuchasene ezininzi.