Abavimbela isiteshi se-calcium yiqembu elikhulu lezidakamizwa ezisetshenziselwa ukwelapha izinkinga eziningana zezinhliziyo ezinjenge- angina , umfutho wegazi ophakeme , i -tachycardia engaphezulu , kanye ne- hypertrophic cardiomyopathy .
Sibutsetelo
Abavimbela isiteshi se-calcium bavimbela i-calcium ukuthi ingangeni emangqamuzaneni enhliziyo, futhi ibe ngamaseli abushelelezi obuhlungu abangela ukuba imithwalo yegazi igxile.
Ngokunciphisa i-calcium influx, abavimbela isiteshi se-calcium babangela ukuthi la maseli e-muscle "aphumule." Lo mphumela wokuphumula ukhombisa ukuhlanjululwa kwemithanjeni yegazi, kanye nokunciphisa amandla okuchotshozwa kwesisu senhliziyo.
Amanye ama-blockers esiteshini se-calcium abuye aphuze i- node ye-sinus kanye nesilinganiso lapho ukuzwa kwe-electrical hearings kudlulisa nge- node ye - AV . Lezi zenzeko zenza i-calcium blockers ewusizo ekuphatheni amanye ama- arrhythmias .
Yonke imiphumela ye-calcium blockers (i-blood vessel dilation, ukunciphisa kwenhliziyo ye-muscle contraction, kanye nezinga lentliziyo elincane) kuncishisa inani le-oksijini edingekayo nge-muscle yenhliziyo.
Ukunciphisa inani le-oxygen elisetshenziswe yinhliziyo livumela inhliziyo ukuba isebenze isikhathi eside ngaphandle kokuthuthukisa ischemia , ngisho nalapho igazi ligeleza emithanjeni ye-coronary ivinjelwe kancane nge- plaque atherosclerotic . Ezigulini ezinama- angina azinzile , ama-calcium blockers ngokuvamile akhulisa inani lokuzivocavoca okungenziwa ngaphambi kokuba i-angina ivele.
Ama-blockers e-calcium angasiza kakhulu kuziguli ezine- angina ye-Prinzmetal (i-coronary artery spasm) ngoba zingakwazi ukuvimbela ngokuqondile ukusabalala kwemithambo ye-coronary.
Izinhlobo
Amakhasimende amaningi e-calcium asemakethe, futhi akuzona zonke ngokufanayo. Kunezinhlobo ezintathu zama-blockers asetshenziswa kabanzi:
1) I-dihydropyradines .
Imithi nifedipine (Procardia, Adalat), i-nicardipine (Cardene), i-felodipine (i-Plendil), ne-amlodipine (i-Norvasc), ibizwa ngokuthi i-dihydropyridines. Lezi zidakamizwa zibangela ukukhuphuka okuphawulekayo kwemithwalo yegazi nomphumela omncane kakhulu emzimbeni nasenhliziyweni. Ziwusizo kakhulu ekuphatheni umfutho wegazi ophezulu.
2) I- Verapamil. I-Verapamil (i-Calan, iCovera, i-Isoptin, i-Verelan) iyathinta imisipha yenhliziyo futhi iyasebenza ngokuphumelelayo ekunciphiseni izinga lokushaya kwenhliziyo, kodwa ayinethonya elincane emithanjeni yegazi. Akusizi kakhulu ukushisa komfutho wegazi kodwa kuhle kakhulu ku-angina ne-arrhythmias ye-cardiac.
3) i- Diltiazem. I-Diltiazem (i-Cardizem, i-Dilacor, i-Tiazac) inezimo ezinesizotha kokubili imisipha yenhliziyo nemithambo yegazi. Kuvame ukubekezelelana kangcono kunezinye eziningi zokuvimbela i-calcium
Ukusetshenziswa
Ukwelashwa kuka-Angina
Zonke izivimbela ze-calcium ziye zasetshenziselwa ukwelapha i-angina. Noma kunjalo, ama-blockers amaningi asetshenzisiwe asetshenziswa kakhulu yi-formti-acting form of diltiazem ne-verapamil, i-amlodipine, noma i-felodipine.
I-Nifedipine, ikakhulukazi amafomu ayo ama-short acting, kufanele ngokuvamile agwenywe ezigulini ezine-angina, ngoba i-blood propellation eyenziwe yilezi zidakamizwa ingakhuphuka ku-adrenaline, eholele ekutheni i-adrenaline iyashesha, futhi ngenxa yalokho ukwanda kwezidingo zomoya-mpilo ( okuyinto engandisa amathuba okuthuthukisa ischemia yenhliziyo).
Ngokuvamile, kuyilapho i-calcium blockers ingasiza ekunciphiseni i-angina, ibhekwa njengaphansi kwebhea blockers . Izincomo zamanje ziyi:
- Abavimbela i-calcium kufanele bavijiswe ezigulini ezingenakubekezelela ukuvimbela i-beta blockers.
- Abavimbela i-calcium kufanele bengezwe kuma-beta blockers ezigulini ezingenayo imali eyanele yezimpawu nge-beta blockers.
Okunye ukusetshenziswa okuvamile
- I-hypertension. I-dihydropyradine calcium blockers iyasiza kakhulu ekuphatheni umfutho wegazi ophezulu, futhi ngokuvamile isetshenziswa njengendlela yokwelashwa kokuqala ye-Stage I-high blood pressure. Funda ngokukhetha imithi "efanele" yomshuwalense.
- Ama-arrhythmi angaphezulu. Abavimbela i-calcium (ikakhulukazi i-verapamil) kuvimbela kancane ukusebenza kwe-AV node, ngakho-ke kuvame ukuwusizo ekuphatheni ama-arrhythmi asezingeni eliphezulu elithembela ku-node ye-AV ukuze iqhubeke. Ikakhulukazi, i- AV nodal reentrant tachycardia (uhlobo oluvame kakhulu lwe-arrhythmia) lungavame ukulawulwa nge-verapamil therapy.
- I-cardiomyopathy ye-hypertrophic. Ama-block block ka-calcium angasetshenziswa ukusiza ukunciphisa "ukuqina" kwe-ventricle kwesokunxele kubantu abane-hypertrophic cardiomyopathy, futhi ngale ndlela kunganciphisa izimpawu.
Okuqhamuka uma udla imishanguzo
Imiphumela emibi evamile ye-calcium channel blockers ihlanganisa ikhanda, isizungu, ukuqhuma, nezinyawo nokuvuvukala kwe-ankle. I-Verapamil, ikakhulukazi, ibuye ibangele ukumbumbuluzwa.
Ngenxa yokuthi abalandeli be-calcium bavame ukunciphisa amandla okuchotshozwa kwemisipha yenhliziyo, kufanele basebenzise ngokuqapha (uma kunjalo) ezigulini ezinenhliziyo .
Ngokuvamile kungcono ukugwema i-verapamil ne-diltiazem kubantu abane- bradycardia kusukela lezi zidakamizwa zizophuthuma izinga lokushaya kwenhliziyo.
> Imithombo:
> Gersh BJ, Maron BJ, Bonow RO, et al. Umhlahlandlela we-ACCF / AHA we-AHA wokuHlola nokuPhathwa kwe-Cardiomyopathy Hypertrophic: Isifinyezo Esiphezulu: Umbiko we-American College of Cardiology Foundation / i-American Heart Association Task Force on Guidelines Practice. Ukujikeleza ngo-2011; 124: 2761.
> Fihn SD, Gardin JM, Abrams J, et al. 2012 I-ACCF / AHA / ACP / AATS / PCNA / SCAI / STS Umhlahlandlela wokuHlola nokuPhathwa kweziPhathi ezine-Stable Ischemic Heart Disease: Umbiko we-American College of Cardiology Foundation / i-American Heart Association eqenjini lemikhakha yokufundisa, ne-American College of Physicians, American Association for Thoracic Surgery, Ukuvimbela Inesi Abahlengikazi Association, Society for Cardiovascular Angiography and Ukungenelela, kanye Society of Thoracic Abahlinzayo. Ukujikeleza ngo-2012; 126: e354.
> Mancia G, Fagard R, Narkiewicz K, et al. Imihlahlandlela ye-ESH / ESC ka-2013 yokuphathwa kwe-Hypertension Eyingozi: I-Task Force Yokuphathwa Kwe-Hypertension Ye-Arterial Hypertension (ESH) ne-European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281.