I-nitrate ibe yindlela esemqoka ekwelapheni i-angina iminyaka engaphezu kwengu-100. Namuhla, i-nitrate isetshenziselwa kokubili ukuphatha iziqephu ezinzima ze-angina (ngesimo se-nitroglycerin esingaphansi kombhalo noma i-nitroglycerin spray oral), futhi engapheli (ifomu lesipilisi noma njengesikhumba sesikhumba) ukusiza ukuvimbela angina.
AmaNitrate Asebenza Kanjani?
I-nitrate isebenza ngokukhipha imithanguzo nemithanjeni, kokubili enhliziyweni nakwezinye izindawo emzimbeni.
Lokhu kuncibilika kwemithambo yegazi kunciphisa ukucindezeleka emzimbeni wenhliziyo, ngaleyo ndlela kunciphisa inani le-oksijithali inhliziyo edingayo. Ukunciphisa izidingo ze-oksijeni zenhliziyo kuvumela inhliziyo ukuba yenze umsebenzi ongaphezulu ngaphandle kokuthuthukisa ischemia , ngisho noma igazi ligeleza emithanjeni ye-coronary ivinjelwe kancane nge- atherosclerosis .
I-nitrate iphinde ihlise imishanguzo ye-coronary. Njengoba i-coronary artery isivele ihlanjululwe lapho i-atherosclerotic plaque ivimbela ukugeleza kwegazi, lokhu kuhlaziya okuqondile kungokusetshenziswa okulinganiselwe kubantu abanesifo somzimba we-coronary . Kodwa-ke, kubantu abane- Prinzmetal angina - eyabangelwa kakhulu yi-artery corasary spasm - nitrate ngokuvamile iyasiza kakhulu.
I-Nitrates Isetshenziswa Kanjani?
I-nitroglycerin (i-nitroglycerin ebizwa ngokuthi i-nitroglycerin (i-nitroglycerin esheshayo isuka ngaphansi kolimi) iyindlela edala kunayo yonke ye-nitrate therapy. I-SL nitroglycerin yindlela esheshayo yokukhulula isiqephu se-angina esenzelwe ukuvivinya umzimba noma ukucindezeleka, futhi kuvame ukuhlinzeka impumuzo phakathi nemizuzu.
Futhi, ukuthatha i-SL nitroglycerin nje ngaphambi kokuba uhlanganyele emisebenzini engabangela izimpawu (njengokukhwela intaba noma ukuhamba emakhazeni) kungasiza ekuvimbeleni iziqephu ze-angina. I-SL nitroglycerin iqala ukuhlanza imithwalo yegazi phakathi kwemizuzu emibili, futhi umphumela wayo ungadlula imizuzu engama-30.
I-nitrolyerin spray, eyiswe emlonyeni ngedivaysi ye-doered metered, isebenza ngokufanayo ne-SL nitroglycerin - imane nje enye indlela yokuletha umthamo osebenza ngokushesha we-nitroglycerin.
I-nitrate emifushane emfushane (SL noma izilinganiso ezilinganiselwe) kufanele yenziwe yinoma ubani ophathwa nge-angina.
I-nitrate ende eyenziwa isikhathi eside (amaphilisi noma isikhumba esikhwameni) kubhekwa njengendlela yokwelapha yesibili ye-angina. Kunqunywe ukuthi i- beta blockers (i-first-line therapy) ayikwazi ukubekezelela, noma ayikwazi ukuqeda izimpawu.
Ifomu lepilisi elisetshenziselwa kakhulu i-nitrate yi-isosorbide dinitrate (i-Isordil, i-Sorbitrate). Nge-nitrate yomlomo, umphumela emithanjeni yegazi iqala kungakapheli imizuzu engama-30, futhi ihlala amahora ayisithupha.
I-nitroglycerin yokuguqula i-transdermal, ehambisa i-nitroglycerin ngesikhumba, inikeze ukwelashwa kwe-nitrate ephumelelayo amahora ayisishiyagalolunye kuya kwangu-14.
Ukubekezelelana kweNitrate
Inkinga enkulu ekusetshenzisweni kwe-nitrate ende esebenza isikhathi eside kube yinto "yokubekezelelana." Ukubekezelelana kwe-nitrate kusho ukuthi izinzuzo zokwelashwa kwe-nitrate zingancipha uma i-nitrate isetshenziswe ngehora. Ukukhuluma nje, lapho imithwalo yegazi ihlale ikhonjiswe ku-nitrate, iyeka ukuxubha ekuphenduleni i-nitrate, futhi umphumela wokulwa nomngane we-medication uyanyamalala.
Ukubekezelelana kwe-nitrate kungavinjelwa ngokuhlela ukuhlolwa kwe-nitrate yokwelashwa okungapheli ukuhlinzeka ngezikhathi zansuku zonke ze-nitrate.
Ngakho-ke: i-nitrate yomlomo noma i-nitrate isikhumba sesikhumba kufanele sisetshenziswe amahora angu-12 kuya kwangu-16 ngosuku, ngehora lesishiyagalolunye kuya kweyisishiyagalolunye "isikhala se-nitrate-free". Kulezi ziguli eziningi kusho ukuthi i-nitrate isetshenziswa ngesikhathi sokuvuka, hhayi ngesikhathi sokulala. Kwezinye iziguli ezine-angina emnyama, noma kunjalo, isikhashana sama-nitrate singadinga ukuhlelwa ngesikhathi sokuvusa.
Okunye Ukuqapha NgeziNitrate
Ama-nitrate akufanele asetshenziswe ezigulini ezine- cardiomyopathy (okungukuthi i-nitrate ingabangela ingozi eyingozi ekugezeni kwegazi ngaphakathi kwenhliziyo), noma ezigulini ezithatha i-Viagra (sildenafil) noma ezinye izinsimbi ezifanayo zokungasebenzi kahle kwe-erectile.
( Ukuthatha i-nitrate ne-Viagra ndawonye kungabangela ukucindezeleka okukhulu - umfutho wegazi ophansi.)
Ama-Asiya athambekele ekuphenduleni okunciphise ama-nitrate, futhi angenakuthola kancane ukuthola inzuzo ekusebenziseni kwabo.
Imiphumela emibi kakhulu ye-nitrate yilezikhanda futhi ihlwitha, nakuba ubukhulu be-hypotension bungaba khona. Iziguli ezinomlando wezinhlungu ze- migraine ngokuvamile azikwazi ukubekezelela i-nitrate.
Imithombo:
Fihn SD, Gardin JM, Abrams J, et al. 2012 I-ACCF / AHA / ACP / ATS / PCNA / SCNA / I-STA / Isiqondiso se-STS sokuxilongwa nokuphathwa kweziguli ezinesifo senhliziyo esisimeme: isishwankathelo esiphezulu: umbiko we-American College of Cardiology Foundation / i-American Heart Association emithethweni yokuziphatha, kanye ne-American College of Physicians, i-American Association ye-Thoracic Surgery, i-Preventive Cardiovascular Nurses Association, i-Society for Cardiovascular Angiography and Interventions, kanye neNhlangano Yabahlengikazi BamaTrracic. Ukujikeleza ngo-2012; 126: 3097.