Iziyobisi Anticholinergic: list. Indlela yokusebenza ye kwichiza anticholinergic

amachiza Anticholinergic - iziyobisi ukuvimba yintshukumo neurotransmitter yendalo - acetylcholine - to nezamkeli cholinergic. Yoncwadi amazwe, eli qela iziyobisi ngokuba "delirianty" ngenxa ubuchule ukubangela tremens.

A bit of amanqaku ngembali

Ekuqaleni, kwinkulungwane yama-20, iziyobisi amanyathelo anticholinergic ezisetyenziselwa ukunyanga ezondeleyo izifo obstructive pulmonary kunye isifuba, kodwa ke indawo ngaphezu ziziyobisi mihla kunye neziphumo ezimbalwa ibangela. Ngophuhliso Pharmacology, oosonzululwazi baye bakwazi ukuphuhlisa holinoblokatory yokuba azinazo uluhlu enye enkulu yeziphumo ebezingalindelekanga. Iifom Izikali ziye zaphucuka, yaye izifo pulmonary practice enyangayo zilandelayo kwakhona anticholinergics. Indlela yokusebenza ye eli qela iziyobisi kuba kunokuba nzima, kodwa unako ukuchaza links eziphambili.

ntoni holinoblokatory njani?

Okwenziwayo beziyobisi anticholinergic leyo ethintela receptors cholinergic kwaye akunakwenzeka eziphembelela kubo neurotransmitter - acetylcholine. Umzekelo, kwi bronchi ezivaliweyo receptors ibekwe esihlunwini kakuhle.

ngezigaba amachiza

Ngokuxhomekeke kuyo receptors baphenjelelwa ziziyobisi anticholinergic, uluhlu yahlulwe ngamaqela:

• M-holinoblokatory (atropine, scopolamine, bromide ipratropium).
• H holinoblokatory (pentamine, tubocurarine).

Kuxhomekeka selectivity amanyathelo:

• Central, okanye non-uyakhetha (atropine, pirenzepine, platifillin).
• Neuropathy okanye uyakhetha (ipratropium bromide).

M-holinoblokatory

Ummeli engundoqo eli qela iziyobisi yi atropine. Atropine - an alkaloid, apho ikhoyo nokubakho kwezinye izityalo ezifana nightshade ezibulalayo, henbane kunye datura. Eyona nto abuthethileyo of atropine - antispasmodic. Ngokuchasene imvelaphi wesenzo kunciphisa kwezihlunu wokugaya, lwesinyi bronchus.

Atropine emiselweyo ngomlomo, kwesikhumba kunye yegazi. ubude bayo amanyathelo ngeeyure eziyi-6 kunye nokusebenzisa atropine amathontsi ukunyuka ixesha iintsuku ezisixhenxe.

imiphumela amayeza of atropine:

• abafundi inimba amehlo ngenxa isiphumo emnandi esihlunwini elijekelezayo lwe iris - izihlunu samehlo phumla, ngokulandelelana, umfundi dilates. Isiphumo esiphezulu lwenzeka kwimizuzu 30-40 emva instillation.
• Ukukhubazeka yokuhlala - lens bulukwe ibe atshabalalisa, iziyobisi anticholinergic zivulelwe iliso ezikude.
• izinga intliziyo Ukwandisa
• Ukunyenyiswa zihlunu kwamagingxi kwi bronchi, iphecana zesisu, isinye womchamo.
• Okwehlileyo namadlala secretion lwangaphakathi, ezifana inyumoniya, yokucola kunye nokubila.

Ukusetyenziswa atropine

• Zamehlo: isifundo fundus, inkcazelo esiphoso zokunganyangeki.
• Xa zentliziyo, atropine sisetyenziselwa bradycardia.
• Xa Pulmonology wasebenzisa iziyobisi anticholinergic somoya.
• Gastroenterology: isilonda esiswini kunye isilonda duodenal, gastritis giperatsidnom (ngokunciphisa esiswini acid secretion amadlala zokugaya). Ichiza kakuhle xa yokulunywa emathunjini.
• Le anesthetists atropine isetyenziswe premedication phambi iinkqubo ezahlukeneyo yotyando.

iziphumo ebezingalindelekanga atropine.

Luphawulwa kome emlonyeni nasemqaleni, photophobia, kufuphi umbono kakuhle, ukuqhina, ubunzima ukuchama.

Atropine ke contraindicated ngokupheleleyo ukusebenzisa ukunyanga iglaucoma agalelwa ngenxa isiphumo sokwandisa uxinzelelo intraocular. Contraindicated iziyobisi anticholinergic ukuba ngumchamo wokuchama, njengoko imisipha lwesinye. Anticholinergics ifuna Ukukhetha ngqo nomthamo. Ngeedosi kwemfuneko iza Ityhefu ephilayo, esibonakala yi motor kunye nokuvuka ngokweemvakalelo, mydriasis, hoarseness, ubunzima igwinya, nivuke in lobushushu. Xa izigulane kakhulu ngakumbi ityhefu aqala ukulahlekelwa yokuqhelaniswa zabo isithuba, akusekho ingqalelo abantu ngeenxa zonke kubo, ebonakalaliswe nemibono kunye iimfeketho zokufeketha. Ngamana ukuphuhlisa uhlaselwe ukuba baye isiqaqa, kodwa ngenxa ukushwabana iziko yokuphefumla, ukufa kwenzeka ngokukhawuleza. Eyona novelwano ngeedosi kwemfuneko abantwana - ithamo babo ebulalayo 6-10 mg.

Scopolamine ezakheke efanayo atropine, kodwa ngokuchaseneyo inika iziphumo ubukhulu becala inhibitory kwinkqubo luvo, osebenza sine. Le propati isetyenziswe kulo mkhuba yamayeza - scopolamine lisetyenziswa ezahlukeneyo ukuphazamiseka kwenkqubo vestibular - nesiyezi, iqinelwa kakuhle kunye ukulingana, ukuthintela uphuhliso elwandle kunye nokugula nomoya.

Amachiza Anticholinergic zifakwe kwi "Aeron," ichiza elo isoloko isetyenziswa phambi kokuba uhambo oluzayo kwi iinqwelo kunye neenqanawa. Amacwecwe Action buhlala ngeeyure eziyi-6. Kukho ifomu netabletirovannaya - inkqubo transdermal unyango - ukutyabeka, nto leyo ethe kwi indlebe kunye oyiyekayo ichiza ngaphezu kweeyure ezingama-72. La machiza anticholinergic - lakhula, kwiimeko oluphambili kakhulu kunceda ekwandiseni ngokukhawuleza imimoya izigulane aba ntshikilelo lowukulu.

Ipratropium bromide ( "Atrovent") - a bronchodilator. Xa ukusebenzisa inhalation ngokubonakalayo kwelifunekayo, ibe ligazi kwaye akukho neziphumo zenkqubo yezemfundo. Ngenxa kuvalwe iindlela receptors cholinergic zezihlunu agudileyo bronchi yenza ukwanda lwabo. Ezi anticholinergics ezikhoyo njengoko isisombululo ibe inhaler zetoti, okanye ukudityaniswa kwaye zisebenza somoya inyumoniya kunye COPD. side effects - isicaphucaphu umlomo owomileyo.

Tiotropium bromide - amachiza anticholinergic kwiipropati ezifana bromide ipratropium. Oveliswa ngokohlobo olungumgubo inhalation. A isici esasenza eli chiza kukuba ifuthe ngakumbi nehlala receptors cholinergic, ke ngoko, yeyokuba isebenza kakhulu ngaphezu bromide ipratropium. Lusetyenziswa izigulane COPD.

Platifillin - Araneus alkaloid. Ngokungafaniyo nezinye anticholinergics, platifillin nako zithambe imithambo yegazi. Ngenxa kule propati, kukho ukuhla okungephi uxinzelelo lwegazi. Ichiza Zakhululwa isisombululo kwaye suppositories efakwa. Faka kunye ziba nemikhinkqi agudileyo enyama yangaphakathi, isibindi kunye yokulunywa kwezintso, isifuba, kwakunye neentlungu okubangelwa spasm kunye isilonda etsolo esiswini kunye isilonda duodenal. In ophthalmological platifillin yokusebenza esetyenziswa ngokohlobo wamehlo ukuba abafundi inimba.

Pirenzepine - preferentially iibhloko iiseli esiswini ukuvelisa histamine. Ngokunciphisa ukukhululwa histamine kunciphisa ulwabiwo zehydrochloric acid. Ngokwemithamo yesiqhelo unyango, eli chiza phantse nafuthe abafundi kunye ukubetha kwentliziyo, ngoko ngokusisiseko pirenzepine ithathwa ngomlomo ngenxa yonyango kwethumba esiswini kunye isilonda duodenal.

H holinoblokatory (ganglionic)

Indlela yokusebenza kukuba arhente anticholinergic eli qela evalela i innervation novelwano nemithambo parasympathetic komse- ukunciphisa secretion adrenaline kunye noradrenaline, zinqanda excitation le bokuphefumla iziko vasomotor. Ngaphezu koko, kukokona impembelelo innervations unovelwano okanye parasympathetic, manifest ngakumbi inyathelo lwekeyboard.

Umzekelo, isixa abafundi bomelele parasympathetic iimpembelelo innervation - ngokuqhelekileyo abafundi uqobo iingqameko. Kulo mzekelo, holinoblokatory kuya kuchaphazela inkqubo parasympathetic luvo - ngenxa abafundi ukuba inimba. Phantse yonke imithambo yegazi phantsi kwempembelelo kwenkqubo onovelwano nervous - iziyobisi kuphelisa impembelelo yayo zithambe imithambo yegazi, ngenxa apho uxinzelelo lifinyele.

H holinoblokatory ilifa ukusebenza bronchodilatory kwaye zisetyenziselwa spasm inyumoniya, ukunciphisa isandi lwesinye, ngoko aba linokukwenziwa kwi anticholinergics ukuchama nzima. Ukongezelela, la machiza ukuthoba kwamadlala secretion lwangaphakathi, ngokunjalo isantya iphecana motility zesisu. Xa yezonyango, wasebenzisa isiphumo ikakhulu iqinile, nto leyo ilifa ezi anticholinergics. Uluhlu yeziphumo ebezingalindelekanga kumba:

• Ngomhla inxalenye wokugaya: umlomo owomileyo nokuqunjelwa.
• Ukususela isixokelelwano sokuphefumla: ukukhohlela, aphazamiseke zasekuhlaleni ukuze nayo.
• Ukusuka CCC: arrhythmia, iyangongoza ngayo. Ezi mpawu zinqabile yaye lula basuswe.
• Okunye Iziphumo kunganciphisa acuity ezibonwayo, uphuhliso uhlobo nokoyika ukunyanga iglaucoma agalelwa, nokudumba.

Izimo ukuba ukusetyenziswa kweziyobisi anticholinergic

• Hypersensitivity ukuba ahlobene of atropine kunye namanye amacandelo amalungiselelo.
• Pregnancy (ingakumbi 1 ezintathu).
• Zisanyisa.
• yobudala yabantwana (contraindication isihlobo).
• ukusetyenziswa Eyona contraindicated lwamachiza e-engile-ukuvalwa neglaucoma kwizigulane kunye ukusilela kwezintso kuyimfuneko ukuba esweni ngenyameko imeko igazi nomchamo.